Low dose vaginal misoprostol vs vaginal dinoprostone insert for induction of labor beyond 41st week: a randomized trial

De Bonrostro Torralba, C. (Universidad de Zaragoza) ; Tejero Cabrejas, E.L. ; Envid Lázaro, B.M. ; Franco Royo, M.J. ; Roca Arquillué, M. ; Campillos Maza, J.M. (Universidad de Zaragoza)

Resumen: Introduction: The aim of this study was to compare the efficacy and safety of a low‐dose protocol of vaginal misoprostol and vaginal dinoprostone insert for induction of labor in women with post‐term pregnancies. Material and methods: We designed a prospective, randomized, open‐labeled trial with evaluators blinded to the end‐point, including women of at least 41 weeks of gestational age with uncomplicated singleton pregnancies and a Bishop score <6. They were randomized into dinoprostone or misoprostol groups in a 1:1 ratio. Baseline maternal data and perinatal outcomes were recorded for statistical analysis. Successful vaginal delivery within 24 hours was the primary outcome variable. A P value <0.05 was considered statistically significant. This study was registered in ClinicalTrials.gov (number NTC03744364). Results: We included 198 women for analysis (99 women in each group). Vaginal birth rate within 24 hours did not differ between groups (49.5% vs 42.4%; P = 0.412). When the Bishop score was <4, dinoprostone insert showed a higher probability of vaginal delivery within 12 hours (17.8% vs 4%; P = 0.012). In the dinoprostone group, removal of the insert was more likely to be due to an adverse event (5.1% vs 14.1%; P = 0.051) and an abnormal fetal heart rate pattern during active labor (44.4% vs 58.6%; P = 0.047). Both groups were similar in neonatal outcomes including Apgar score, umbilical cord pH and neonatal intensive care unit admission. Conclusions: Low‐dose vaginal misoprostol and vaginal dinoprostone insert seem to be equally effective and safe for induction of labor in pregnant women with a gestational age beyond 41 weeks.

Idioma: Inglés

DOI: 10.1111/aogs.13556

Año: 2019

Publicado en: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 98, 7 (2019), 913-919
ISSN: 0001-6349

Factor impacto JCR: 2.77 (2019)

Categ. JCR: OBSTETRICS & GYNECOLOGY rank: 23 / 82 = 0.28 (2019) - Q2 - T1

Factor impacto SCIMAGO: 1.254 - Obstetrics and Gynecology (Q1) - Medicine (miscellaneous) (Q1)

Tipo y forma: Artículo (PostPrint)

Área (Departamento): Área Obstetricia y Ginecología (Dpto. Cirugía,Ginecol.Obstetr.)