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Comparison of labor induction with misoprostol vs. oxytocin/prostaglandin E 2 in term pregnancy
Author(s) -
Kadanali S.,
Küçüközkan T.,
Zor N.,
Kumtepe Y.
Publication year - 1996
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(96)02710-5
Subject(s) - misoprostol , oxytocin , medicine , labor induction , obstetrics , intravaginal administration , bishop score , pregnancy , prostaglandin e2 , vaginal delivery , prostaglandin , induction of labor , prostaglandin e1 , adverse effect , dinoprostone , incidence (geometry) , anesthesia , abortion , gynecology , cervix , vagina , surgery , biology , genetics , physics , cancer , optics
Objective: To compare the efficacy and safety of intravaginal and oral misoprostol vs. oxytocin/prostaglandin E 2 (PGE 2 ) gel for third trimester labor induction. Methods: Two hundred twenty‐four pregnant women were randomized to induction of labor either with misoprostol or oxytocin and PGE 2 gel. Patients in the misoprostol group (n = 112) received 100 μg intravaginal misoprostol followed by 100 μg p.o. every 2 h. The oxytocin/PGE 2 group consisted of 112 patients who underwent PGE 2 cervical instillation 6 h before continuous oxytocin infusion. The perinatal, intrapartum and neonatal characteristics of both groups were determined. Results: Induction to active phase of labor was successfully achieved in 96 women (85.7%) in the misoprostol group vs. 86 women (76.8%) in the oxytocin/PGE 2 group, but the drug initiation‐delivery interval was significantly shorter in the misoprostol group (9.2 ± 2.4 h) than in the oxytocin/PGE 2 group (15.2 ± 3.2 h, P < 0.001). The incidence of adverse intrapartum outcomes was similar for both methods. Intravaginal misoprostol 100 μg followed by a single oral dose of 100 μg misoprostol safely produced labor and a vaginal delivery in 70% of patients. More than three tablets were required in only 10% of patients. There was a higher prevalence of cesarean section for failed induction in the oxytocin/PGE 2 group than in the misoprostol group (13.4 vs. 6.3%, P < 0.001). The neonatal outcomes of both groups were also similar. Conclusion: Misoprostol is significantly more effective for labor induction than oxytocin/PGE 2 gel. The maternal intrapartum and neonatal outcomes were the same for both induction regimens. From a clinical and perinatal perspective, misoprostol is an acceptable choice for labor induction.