Vaginal dinoprostone insert compared with two different oral misoprostol regimens for labor induction in nulliparous and multiparous women.
dinoprostone
dosage
labor induction
misoprostol
regimen
safety
time to delivery
Journal
Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
Titre abrégé: Acta Obstet Gynecol Scand
Pays: United States
ID NLM: 0370343
Informations de publication
Date de publication:
02 Sep 2024
02 Sep 2024
Historique:
revised:
23
07
2024
received:
18
03
2024
accepted:
01
08
2024
medline:
3
9
2024
pubmed:
3
9
2024
entrez:
2
9
2024
Statut:
aheadofprint
Résumé
Labor induction exhibits considerable variations in protocols and medication regimens. Limited studies compare vaginal dinoprostone inserts with different oral misoprostol dosages, considering parity influence. This study explores the distinctions among 10 mg vaginal dinoprostone inserts and oral misoprostol 25 μg every 2 and every 4 h for labor induction, stratified by parity. This retrospective cohort study involved 607 participants across two hospitals. The primary outcome, time from induction to delivery, and secondary outcomes, including mode of delivery and maternal and fetal safety, were assessed. Patient characteristics revealed differences in indication for labor induction, with the dinoprostone cohort having fewer post-term and premature rupture of membranes cases but more intrauterine growth restriction/small-for-gestational age. Both oral misoprostol regimens showed a shorter time to delivery interval compared to the dinoprostone cohort (median: 1380 min [IQR 1381.0] and 1127.0 min [IQR 1214.0] versus 1631.5 [IQR 1736.2], p < 0.001 and p = 0.014). Only the difference between oral misoprostol q2h and vaginal dinoprostone remained significant for nulliparous but not multiparous women, losing significance over all the population after adjusting for confounding factors. The proportion of women giving birth within 24 h did not significantly differ between misoprostol q2h and dinoprostone after adjusting for confounders. When comparing misoprostol q4h with dinoprostone after confounder adjustment, an increased time to delivery interval for misoprostol q4h was found (p = 0.001). Both oral misoprostol regimens exhibited fewer meconium-stained liquor (miso q4h: OR 0.44, miso q2h: OR 0.34) and cesarean sections (miso q4h: OR 0.48, miso q2h: OR 0.53) compared to dinoprostone, even after adjustment for confounders. Our study suggests that oral misoprostol 25 μg q4h is less effective than 10 mg vaginal dinoprostone for labor induction if parity and indication for induction are adjusted for, particularly in multiparous women. In terms of side effects, oral misoprostol regimens seem superior to vaginal dinoprostone. Our data support the individualized use of different agents for labor induction according to parity, indication for induction, bishop score, and women's preference.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Author(s). Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).
Références
Macfarlane A, Dattani N. European perinatal health report. Health and Care of Pregnant Women and Babies in Europe in 2010.
Bundesamt für Statistik, Redaktion: Mélanie Riggenbach, BFS. Entbindungen und Gesundheit der Mütter im Jahr 2017. [Federal Statistical Office, Editor: Mélanie Riggenbach, BFS. Births and maternal health in 2017.]. Published online May 2019. https://www.bfs.admin.ch/bfsstatic/dam/assets/8369420/master
AWMF. S2k‐Leitlinie Geburtseinleitung.[ S2k guideline for induction of labor.]. https://register.awmf.org/assets/guidelines/015‐088ladd_S2k_Geburtseinleitung_2021‐04.pdf
Morris JL, Winikoff B, Dabash R, et al. FIGO's updated recommendations for misoprostol used alone in gynecology and obstetrics. Int J Gynecol Obstet. 2017;138:363‐366.
Kehl S, Hösli I, Pecks U, et al. Induction of labour. Guideline of the DGGG, OEGGG and SGGG (S2k, AWMF registry No. 015‐088, December 2020). Geburtshilfe Frauenheilkd. 2021;81:870‐895.
Krause E, Malorgio S, Kuhn A, Schmid C, Baumann M, Surbek D. Off‐label use of misoprostol for labor induction: a nation‐wide survey in Switzerland. Eur J Obstet Gynecol Reprod Biol. 2011;159:324‐328.
Jin J, Zhang Y, Wang ZJ, Zhong M, Yu YH. Risk factors of premature rupture of membranes with neonatal infection: a single‐center study. Nan Fang Yi Ke Da Xue Xue Bao. 2011;31:465‐468.
Ezeanochie M, Olagbuji B, Ande A. Women's concerns and satisfaction with induced labour at term in a Nigerian population. Niger Postgrad Med J. 2013;20:1‐4.
Tilden EL, Lee VR, Allen AJ, Griffin EE, Caughey AB. Cost‐effectiveness analysis of latent versus active labor hospital admission for medically low‐risk, Term Women. Birth. 2015;42:219‐226.
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;18:149.
Misoprostol.org. Dosage Guidelines. https://www.misoprostol.org/dosage‐guidelines/
Kerr RS, Kumar N, Williams MJ, et al. Low‐dose oral misoprostol for induction of labour. Cochrane Database Syst Rev. 2021;6:CD014484.
Lapaire O, Zanetti‐Dällenbach R, Weber P, Hösli I, Holzgreve W, Surbek D. Labor induction in preeclampsia: is misoprostol more effective than dinoprostone? J Perinat Med. 2007;35:195‐199.
Taliento C, Manservigi M, Tormen M, et al. Safety of misoprostol vs dinoprostone for induction of labor: a systematic review and meta‐analysis. Eur J Obstet Gynecol Reprod Biol. 2023;289:108‐128.
Surbek DV, Boesiger H, Hoesli I, Pavic N, Holzgreve W. A double‐blind comparison of the safety and efficacy of intravaginal misoprostol and prostaglandin E2 to induce labor. Am J Obstet Gynecol. 1997;177:1018‐1023.
Dilapan‐S® Cervical Dilator. Dilapan‐S Cervical Dilator Compendium. https://www.dilapans.com/
Radan AP, Amylidi‐Mohr S, Mosimann B, et al. Safety and effectiveness of labour induction after caesarean section using balloon catheter or oxytocin. Swiss Med Wkly. 2017;147:w14532.
JASP. https://jasp‐stats.org/
Bennett K. A masked randomized comparison of oral and vaginal administration of misoprostol for labor induction. Obstet Gynecol. 1998;92:481‐486.
Kaur P, Goel P, Takkar N, Huria A. Randomised controlled trial to compare safety and efficacy of vaginal versus oral route of misoprostol for induction of labour in term pregnancy with unfavourable cervix. Int J Reprod Contracept Obstet Gynecol. 2015;4:1988‐1992.
Pongsatha S, Tongsong T, Somsak T. A comparison between 50 mcg oral misoprostol every 4 hours and 6 hours for labor induction: a prospective randomized controlled trial. J Med Assoc Thail Chotmaihet Thangphaet. 2001;84:989‐994.
Hall R. Oral versus vaginal misoprostol for labor induction. Obstet Gynecol. 2002;99:1044‐1048.
Faucett AM, Daniels K, Lee HC, El‐Sayed YY, Blumenfeld YJ. Oral misoprostol versus vaginal dinoprostone for labor induction in nulliparous women at term. J Perinatol. 2014;34:95‐99.
Rane S, Guirgis R, Higgins B, Nicolaides K. Models for the prediction of successful induction of labor based on pre‐induction sonographic measurement of cervical length. J Matern Fetal Neonatal Med. 2005;17:315‐322.
Greenberg MB, Cheng YW, Sullivan M, Norton ME, Hopkins LM, Caughey AB. Does length of labor vary by maternal age? Am J Obstet Gynecol. 2007;197:e1‐e7.
Pevzner L, Powers BL, Rayburn WF, Rumney P, Wing DA. Effects of maternal obesity on duration and outcomes of prostaglandin cervical ripening and labor induction. Obstet Gynecol. 2009;114:1315‐1321.
Faltin‐Traub EF, Boulvain M, Faltin DL, Extermann P, Irion O. Reliability of the bishop score before labour induction at term. Eur J Obstet Gynecol Reprod Biol. 2004;112:178‐181.
Zhao L, Lin Y, Jiang T, et al. Prediction of the induction to delivery time interval in vaginal dinoprostone‐induced labor: a retrospective study in a Chinese tertiary maternity hospital. J Int Med Res. 2019;47:2647‐2654.
Lyndrup J, Legarth J, Weber T, Nickelsen C, Guldbæk E. Predictive value of pelvic scores for induction of labor by local PGE2. Eur J Obstet Gynecol Reprod Biol. 1992;47:17‐23.
Rojansky N, Tanos V, Reubinoff B, Shapira S, Weinstein D. Effect of epidural analgesia on duration and outcome of induced labor. Int J Gynecol Obstet. 1997;56:237‐244.
Calkins L. Premature spontaneous rupture of the membranes. Am J Obstet Gynecol. 1952;64:871‐877.
Tang OS, Gemzell‐Danielsson K, Ho PC. Misoprostol: pharmacokinetic profiles, effects on the uterus and side‐effects. Int J Gynecol Obstet. 2007;99:S160‐S167.
Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. (Institute for Quality and Efficiency in health care.) misoprostol (Geburtseinleitung)—Nutzenbewertung gemäß § 35a SGB V. [misoprostol (induction of labor)—benefit assessment according to section 35a SGB V.]. Published online November 29, 2021.
Dällenbach P, Boulvain M, Viardot C, Irion O. Oral misoprostol or vaginal dinoprostone for labor induction: a randomized controlled trial. Am J Obstet Gynecol. 2003;188:162‐167.
Wang X, Yang A, Ma Q, Li X, Qin L, He T. Comparative study of titrated oral misoprostol solution and vaginal dinoprostone for labor induction at term pregnancy. Arch Gynecol Obstet. 2016;294:495‐503.
Wang X, Zhang C, Li X, Qi H, Liu Q, Lei J. Safety and efficacy of titrated oral misoprostol solution versus vaginal dinoprostone for induction of labor: a single‐center randomized control trial. Int J Gynaecol Obstet. 2021;154:436‐443.
Freepikcompany. Flaticon. Published 2010. www.flaticon.com