open access
Comparison of Misoprostol versus Dinoprostone for delivery induction among pregnant women without concomitant disease
Affiliations- Department of Obstetrics and Perinatology, University Hospital, Cracow, Poland
- Department of Obstetrics & Perinatology, Jagiellonian University Medical College, Cracow, Poland (employed until 2019)
- Department of Obstetrics & Perinatology, Jagiellonian University Medical College, Cracow, Poland
- Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Cracow, Poland
open access
Abstract
Objectives: Induction of labour is a part of an active prenatal care nowadays and the ideal method of that procedure still
remains to be identified. The purpose of this study was to evaluate effectiveness of misoprostol vaginal insert as compared
to dinoprostone gel for delivery induction in pregnant women without any comorbidities.
Material and methods: It was a retrospective cohort study of 240 pregnant women. The primary study outcome was
successful delivery. Other analysed parameters included time to delivery of a baby, time to the beginning of the first stage
of labour, time to vaginal delivery, and duration of all delivery stages. We compared both methods regarding maternal
complications during and after delivery. We also reviewed neonatal outcomes such as birth weight, birth length and
1-minute Apgar scores.
Results: The patients’ basic characteristics were similar regarding their age, gravidity, parity, height, weight and Bishop
score. Time to any delivery and to the onset of a labour in the misoprostol group versus in the dinoprostone group was
14.5 vs 35.6 h (p < 0.001) and 9.9 h vs 25.3 h (p < 0.001) respectively. The chance of the beginning of labour and the baby’s
delivery over time has been observed to be approximately two times higher for misoprostol as compared to dinoprostone.
Conclusions: Our study showed that using misoprostol vaginal insert in comparison to dinoprostone seems to shorten the
time to beginning of the first stage of labour as well as the time to the delivery itself. Some lower Apgar scores observed
in the misoprostol group requires further investigation.
Abstract
Objectives: Induction of labour is a part of an active prenatal care nowadays and the ideal method of that procedure still
remains to be identified. The purpose of this study was to evaluate effectiveness of misoprostol vaginal insert as compared
to dinoprostone gel for delivery induction in pregnant women without any comorbidities.
Material and methods: It was a retrospective cohort study of 240 pregnant women. The primary study outcome was
successful delivery. Other analysed parameters included time to delivery of a baby, time to the beginning of the first stage
of labour, time to vaginal delivery, and duration of all delivery stages. We compared both methods regarding maternal
complications during and after delivery. We also reviewed neonatal outcomes such as birth weight, birth length and
1-minute Apgar scores.
Results: The patients’ basic characteristics were similar regarding their age, gravidity, parity, height, weight and Bishop
score. Time to any delivery and to the onset of a labour in the misoprostol group versus in the dinoprostone group was
14.5 vs 35.6 h (p < 0.001) and 9.9 h vs 25.3 h (p < 0.001) respectively. The chance of the beginning of labour and the baby’s
delivery over time has been observed to be approximately two times higher for misoprostol as compared to dinoprostone.
Conclusions: Our study showed that using misoprostol vaginal insert in comparison to dinoprostone seems to shorten the
time to beginning of the first stage of labour as well as the time to the delivery itself. Some lower Apgar scores observed
in the misoprostol group requires further investigation.
Keywords
misoprostol; dinoprostone; induction of labor
About this articleTitle
Comparison of Misoprostol versus Dinoprostone for delivery induction among pregnant women without concomitant disease
Journal
Issue
Article type
Research paper
Pages
726-732
Published online
2020-12-31
Page views
1080
Article views/downloads
893
DOI
Pubmed
Bibliographic record
Ginekol Pol 2020;91(12):726-732.
Keywords
misoprostol
dinoprostone
induction of labor
Authors
Teresa Gornisiewicz
Katarzyna Kusmierska-Urban
Hubert Huras
Aleksander Galas
References (13)- Blanc-Petitjean P, Carbonne B, Deneux-Tharaux C, et al. MEDIP study group. Comparison of effectiveness and safety of cervical ripening methods for induction of labour: A population-based study using coarsened exact matching. Paediatr Perinat Epidemiol. 2019; 33(5): 313–322.
- Induction of Labour. Society of Obstetricians and Gynaecologist of Canada Clinical Practise Guideline No 296. J Obstet and Gynecol Canada. 2013; 35: s1–s18.
- Huras H, Radoń-Pokracka M, Górnisiewicz T. Indukcja porodu w świetle aktualnego piśmiennictwa. Ginekol Położ. 2016; 11(1): 21–25.
- Leszczyńska-Gorzelak B, Laskowska M, Oleszczuk J. Comparative analysis of the effectiveness of misoprostol and prostaglandin E(2) in the preinduction and induction of labor. Med Sci Monit. 2001; 7(5): 1023–1028.
- Dögl M, Vanky E, Heimstad R. Changes in induction methods have not influenced cesarean section rates among women with induced labor. Acta Obstet Gynecol Scand. 2016; 95(1): 112–115.
- Bomba-Opoń D, Drews K, Huras H, et al. Indukcja porodu — algorytmy kliniczne. Wytyczne Polskiego Towarzystwa Ginekologów i Położników. Ginekologia i Perinatologia Praktyczna. 2018; 3(1): 23–29.
- Sharp A, Faluyi D, Alfirevic Z. Misoprostol vaginal insert (Mysodelle) versus Dinoprostone intravaginal gel (Prostin) for induction of labour. Eur J Obstet Gynecol Reprod Biol. 2019; 240: 41–44.
- Wing DA, Brown R, Plante LA, et al. Misoprostol vaginal insert and time to vaginal delivery: a randomized controlled trial. Obstet Gynecol. 2013; 122(2 Pt 1): 201–209.
- Górnisiewicz T, Jaworowski A, Zembala-Szczerba M, et al. Analysis of intravaginal misoprostol 0.2 mg versus intracervical dinoprostone 0.5 mg doses for labor induction at term pregnancies. Ginekol Pol. 2017; 88(6): 320–324.
- Bolla D, Weissleder SV, Radan AP, et al. Misoprostol vaginal insert versus misoprostol vaginal tablets for the induction of labour: a cohort study. BMC Pregnancy Childbirth. 2018; 18(1): 149.
- Eriksson A, Jeppesen S, Krebs L. Induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets. BMC Pregnancy Childbirth. 2020; 20(1): 79.
- Maggi C, Mazzoni G, Gerosa V, et al. Labor induction with misoprostol vaginal insert compared with dinoprostone vaginal insert. Acta Obstet Gynecol Scand. 2019; 98(10): 1268–1273.
- Mayer RB, Oppelt P, Shebl O, et al. Initial clinical experience with a misoprostol vaginal insert in comparison with a dinoprostone insert for inducing labor. Eur J Obstet Gynecol Reprod Biol. 2016; 200: 89–93.
