Vol 92, No 6 (2021)
Research paper
Published online: 2021-03-10

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Vaginal dinoprostone and misoprostol are equally safe in labour induction at term whereas dinoprostone is less efficacious for cervical ripening and shortening the time of labour

Maciej Zietek1, Malgorzata Swiatkowska-Freud2, Kinga Grajnert1, Zbigniew Celewicz1, Malgorzata Szczuko3
Ginekol Pol 2021;92(6):428-435.

Abstract

Objectives: The aims of the study is to analyze the effectiveness and safety of the use of intravaginal inserts with prostaglandin analogues: dinoprostone and misoprostol, in the labor induction.
Material and methods: Pregnant women (177), with use of dinoprostone (n = 69) or misoprostol (n = 108) for labor induction were analyzed.
Results: The length of time of delivery differed significantly between primiparous and multiparous women and depended on the type of prostaglandin. The incidence of cesarean sections did not differ significantly in analysed groups. The risk of failed induction was over two-fold higher in the dinoprostone group as compared to misoprostol. A statistically significant longer duration of the first and second stage of labor was observed in primiparous compared to multiparous women as well as differences of cervical ripening were observed. There was no statistically significant relationship between the occurrence of hyperstimulation and worsening the newborns condition determined after delivery.
Conclusions: Vaginal dinoprostone and misoprostol are equally safe in labor induction at term whereas dinoprostone is less efficacious for cervical ripening and shortening the time of labor. There was no advantage of any of the prostaglandins used in increasing the risk of having a child in a worse condition and increasing the percentage of caesarean sections.

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References

  1. Pierce S, Bakker R, Myers DA, et al. Clinical Insights for Cervical Ripening and Labor Induction Using Prostaglandins. AJP Rep. 2018; 8(4): e307–e314.
  2. Yellon SM. Immunobiology of Cervix Ripening. Front Immunol. 2019; 10: 3156.
  3. Kishore AH, Liang H, Kanchwala M, et al. Prostaglandin dehydrogenase is a target for successful induction of cervical ripening. Proc Natl Acad Sci U S A. 2017; 114(31): E6427–E6436.
  4. Kelly AJ, Malik S, Smith L, et al. Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term. Cochrane Database Syst Rev. 2009(4): CD003101.
  5. Menon R. Oxidative stress damage as a detrimental factor in preterm birth pathology. Front Immunol. 2014; 5: 567.
  6. Venkatesh KK, Cantonwine DE, Ferguson K, et al. Inflammatory and oxidative stress markers associated with decreased cervical length in pregnancy. Am J Reprod Immunol. 2016; 76(5): 376–382.
  7. Ledingham MA, Thomson AJ, Young A, et al. Changes in the expression of nitric oxide synthase in the human uterine cervix during pregnancy and parturition. Mol Hum Reprod. 2000; 6(11): 1041–1048.
  8. Kishore AH, Owens D, Word RA. Prostaglandin E2 regulates its own inactivating enzyme, 15-PGDH, by EP2 receptor-mediated cervical cell-specific mechanisms. J Clin Endocrinol Metab. 2014; 99(3): 1006–1018.
  9. Cazorla MQ, Marques AP, Sanmartin J, et al. Effectiveness, safety and costs of labor induction with intravaginal misoprostol versus dinoprostone vaginal insert. Clinical Investigation. 2017; 07(01).
  10. Middleton P, Shepherd E, Crowther C. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev. 2018; 5(5): CD004945.
  11. Tenore JL. Methods for cervical ripening and induction of labor. Am Fam Physician. 2003; 67(10): 2123–2128.
  12. Leduc D, Biringer A, Lee L, et al. CLINICAL PRACTICE OBSTETRICS COMMITTEE, SPECIAL CONTRIBUTORS. Induction of labour. J Obstet Gynaecol Can. 2013; 35(9): 840–857.
  13. Melamed N, Ben-Haroush A, Kremer S, et al. Failure of cervical ripening with prostaglandin-E2 can it be predicted? J Matern Fetal Neonatal Med. 2010; 23(6): 536–540.
  14. Barrios De Tomasi J, Opata MM, Mowa CN. Immunity in the Cervix: Interphase between Immune and Cervical Epithelial Cells. J Immunol Res. 2019; 2019: 7693183.
  15. Yoshida K, Reeves C, Vink J, et al. Cervical collagen network remodeling in normal pregnancy and disrupted parturition in Antxr2 deficient mice. J Biomech Eng. 2014; 136(2): 021017.
  16. Arif R, Mazhar T, Jamil M. Induction of Labor in Primigravid Term Pregnancy with Misoprostol or Dinoprostone: A Comparative Study. Cureus. 2019; 11(9): e5739.
  17. Schmidt M, Neophytou M, Hars O, et al. Clinical experience with misoprostol vaginal insert for induction of labor: a prospective clinical observational study. Arch Gynecol Obstet. 2019; 299(1): 105–112.
  18. Draycott T, van der Nelson H, Montouchet C, et al. Reduction in resource use with the misoprostol vaginal insert vs the dinoprostone vaginal insert for labour induction: a model-based analysis from a United Kingdom healthcare perspective. BMC Health Serv Res. 2016; 16: 49.
  19. 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.
  20. Abdelazim I, Yehia A, Fattah IA, et al. Titrated misoprostol versus dinoprostone for labor induction. Journal of Basic and Clinical Reproductive Sciences. 2016; 5(2): 75.
  21. 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.
  22. Rankin K, Chodankar R, Raymond K, et al. Misoprostol vaginal insert versus dinoprostone vaginal insert: A comparison of labour and delivery outcomes. Eur J Obstet Gynecol Reprod Biol. 2019; 235: 93–96.
  23. Young DC, Delaney T, Armson BA, et al. Oral misoprostol, low dose vaginal misoprostol, and vaginal dinoprostone for labor induction: Randomized controlled trial. PLoS One. 2020; 15(1): e0227245.
  24. Lapuente-Ocamica O, Ugarte L, Lopez-Picado A, et al. Efficacy and safety of administering oral misoprostol by titration compared to vaginal misoprostol and dinoprostone for cervical ripening and induction of labour: study protocol for a randomised clinical trial. BMC Pregnancy Childbirth. 2019; 19(1): 14.
  25. Rugarn O, Tipping D, Powers B, et al. Induction of labour with retrievable prostaglandin vaginal inserts: outcomes following retrieval due to an intrapartum adverse event. BJOG. 2017; 124(5): 796–803.