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A Comparative Study on the Effects of Vaginal Misoprostol and Vaginal Misoprostol Plus Estradiol on labor induction

Journal of Clinical and Nursing Research 2022年第2期6卷 68-75页

作者： Seyedeh Azam Pourhoseini Sara Mirzaeian Masuomeh Mirteimouri Mona Najaf Najafi Fatemeh Tara Farideh Akahlghi Elham Abdollahi Department of Obstetrics and Gynecology School of MedicineMashhad University of Medical SciencesMashhadIran Department of Community Medicine School of MedicineMashhad University of Medical SciencesMashhadIran

Background:Cervical ripening is an important factor in predicting successful labor *** an unfavorable cervix,ripening should be done before *** this study,the effect of misoprostol and that of misoprostol plus estradiol on cervical ripening were ***:This randomized,double-blinded study included a total of 190 pregnant women who were identified for pregnancy termination due to maternal or fetal cause at 37 weeks with Bishop score of less than *** patients were assessed between April 2015 to April 2016 in two university hospitals at northeast Iran(Omol-Banin Hospital and Emam Reza Hospital,Mashhad).The patients who met the inclusion criteria were randomly assigned to two groups:the intervention group(Group A),who received 25 micrograms of vaginal misoprostol plus 50 micrograms of estradiol,and the control group(Group B),who received 25 micrograms of vaginal misoprostol *** was administered at 4-hour intervals until cervical ripening(Bishop score≥8)or upon initiation of active phase in both the *** maximum dosage of misoprostol was three doses,whereas estradiol was administered only ***:In this study,the main causes of pregnancy termination were ROM and *** was no significant statistical difference in the Bishop score between the two groups(P=0.13).In addition,no significant difference was observed in the duration of time for cervical ripening(Bishop≥8)between the two groups(P=0.7).The duration between drug administration to the initiation of active phase and also from active phase to delivery showed no significant differences between the two groups(P=0.49 and 0.24,respectively).There was also no significant difference in the delivery route(operative vaginal delivery or Cesarean section)(P=0.2 and P=0.91,respectively).Conclusion:From this study,the use of misoprostol plus estradiol did not improve cervical ripening or decrease the induction *** studies are recommended to investigate comp

关键词： Misoprostol Estradiol valerate labor induction

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Low-Dose Misoprostol versus Vaginal-Insert Dinoprostone for At-Term labor induction: A Prospective Cohort Study

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Open Journal of Obstetrics and Gynecology 2017年第8期7卷 824-834页

作者： Laura Emilia Munoz Saá María Dolores Martín Ríos María Rosario Noguero Meseguer Department of Obstetrics and Gynecology Rey Juan Carlos HospitalMadridSpain Department of Preventive Medicine Rey Juan Carlos HospitalMadridSpain

Introduction: Given the pharmacological change taking place in Spanish delivery rooms, we designed this study to compare the effectiveness and safety of misoprostol (25 mcg/4h) to 10 mg dinoprostone in its slow-releasing vaginalinsert form to induce at-term labor. Methods: In a prospective cohort study (2013-2015), 401 at-term pregnant women referred for induction (Bishop score ≤ 6), who gave birth at the Rey Juan Carlos Hospital in Móstoles (Madrid, Spain), of whom 241 participants were induced with misoprostol and 160 with dinoprostone. Patients were recruited by non-probabilistic sampling of consecutive cases as the inductions in the Obstetrics Block during the study period were indicated. Results: The cesarean section rate was 14% for the misoprostol group and 19% for the dinoprostone group [RR = 1.38 (95%CI: 0.89 - 2.13), p = 0.145]. No differences were found in the vaginal birth rate in induction [44% vs. 53%, RR = 1.08 (0.90 - 1.29), p = 0.401], nor in the vaginal birth rate in induction was lower in the misoprostol group (15% vs. 39%, p = 0.028). The time between induction and giving birth was shorter for the dinoprostone group (20 h vs. 23.4 h, p = 0.018). Conclusion: Inducing delivery by low-dose misoprostol offers similar effectiveness and safety to induction by dinoprostone in its slow-releasing vaginal-insert form. However, our sample is limited, and few studies are available on the subject. Further analyses to draw solid conclusions are required.

关键词： labor induction Cervical Ripening Misoprostol Dinoprostone

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Cervical Ripening for induction of labor: A Randomized Comparison between Vaginal Misoprostol versus Foley’s Catheter Placement in a Nigeria Tertiary Hospital

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Open Journal of Obstetrics and Gynecology 2021年第3期11卷 252-262页

作者： Matthew Igwe Nwali Joseph Agboeze Vitus Okwuchukwu Obi Arinze C. Ikeotuonye Ikechukwu Ogwudu Ugadu Emmanuel Ajuluchukwu Ugwa Department of Obstetrics and Gynecology Federal Teaching Hospital Abakaliki Nigeria Department of Obstetrics and Gynecology Federal Medical Center Birnin Kudu Nigeria

Background: Cervical ripening is prerequisite of successful induction of labor. Vaginal misoprostol and Foley’s catheter placement have been widely used for this purpose but the data are not always sufficient. We attempted to determine which (misoprostol versus Foley’s catheter) is more effective/safer in Nigerian setting. Methods: A randomized controlled trial was performed at Federal Teaching Hospital Abakaliki, Nigeria, involving 135 term pregnant women requiring cervical ripening and labor induction. Participants were randomly allocated to misoprostol versus catheter group. The following were recorded/measured/analyzed: Bishop’s score, age, parity, body mass index, gestational age, labor duration, indication, oxytocin use, mode of delivery, and Apgar score. Chi square test and t test were used where appropriate. Results: At 24 hours, all of misoprostol group were either in labor, had ripe cervix, or had delivered, whereas 35.4% of catheter group had still unripe cervix (x2 = 29.856, P = 0.0001). Misoprostol group was less likely to require oxytocin infusion (x2 = 52.600,

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Effectiveness and Safety of Double-balloon Catheter versus Intra-amniotic Injection of Ethacridine Lactate for Termination of Second Trimester Pregnancy in Patients with Liver Dysfunction

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2015年第1期35卷 129-134页

作者：李娜吴鹏赵捷冯玲乔福元曾万江 Department of Obstetrics and Gynecology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology

Severe liver dysfunction in pregnancy（SLDP） is rare but serious complications with high mortality rate. This study compared the effectiveness and safety of double-balloon catheter versus intra-amniotic injection of ethacridine lactate for the termination of second trimester pregnancy in patients with SLD. A total of 55 patients with indications of labor induction were enrolled and analyzed by retrospective control analysis method. Twenty-three cases adopted Cook double balloon dilation as Cook group, and 32 cases received intra-amniotic injection of ethacridine lactate as EL group. The primary outcome was evaluated by successful abortion rate and the difference in the induction-to-abortion interval. Secondary outcomes included liver function recovery and the frequency of adverse events. Both Cook and EL regimens were effective, with successful abortion rate of 87.0% and 93.8%, respectively（P=0.639）. The induction-to-delivery interval was similar between Cook group and EL group（38.1±21.5 vs. 41.3±17.4, P=0.543）. The liver disease status was more severe in Cook group than in EL group, but it did not show any significant difference after pregnancy termination between the two groups and the improvement rate also did not show any significant difference. Both treatments were safe and there was no significant difference in bleeding and cervical laceration adverse events between the two groups. Our study firstly compared double-balloon catheter and ethacridine lactate for the induction of labor in women with SLD during second trimester pregnancy.

关键词： severe liver dysfunction labor induction double-balloon catheter mechanical method ethacridine lactate

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How Effective Is Cervical Ripening Using the Controlled-Release Dinoprostone Vaginal Delivery System for Primiparas with Unruptured Membranes?

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1185-1196页

作者： Yoshino Kinjyo Yukiko Chinen Tadatsugu Kinjo Shuko Chinen Keiko Mekaru Department of Obstetrics and Gynecology Graduate School of Medicine University of the Ryukyus Okinawa Japan

Background: labor induction has a low success rate, especially in primiparas with unruptured membranes. Previous studies focused on pregnant women with unruptured membranes, but none specifically targeted primiparas. Aims: To compare the effectiveness of a controlled-release dinoprostone vaginal delivery system for cervical dilatation (PROPESS) with that of mechanical dilation for labor induction in primiparous women with unruptured membranes. Materials and Methods: We retrospectively analyzed the data of 90 primiparas with unruptured membranes (41 and 49 in the PROPESS and mechanical dilation groups, respectively). The primary outcome was the cesarean section (CS) rate. The secondary outcomes were the prevalence of vaginal delivery within 12 or 24 h after the initial insertion, oxytocin usage rate, chorioamnionitis, additional use of mechanical dilation in the PROPESS group, and neonatal outcomes. Results: The CS rate was significantly lower in the PROPESS group than in the mechanical dilation group (p = 0.02). A total of 13 patients (31.7%) delivered within 24 h with PROPESS alone, indicating a significantly higher rate of delivery within 24 h in the PROPESS group (p = 0.02). Fewer patients required additional oxytocin in the PROPESS group than in the mechanical dilation group (p = 0.001). However, 14 (34%) patients in the PROPESS group required additional mechanical cervical dilation, resulting in a longer time to delivery than mechanical dilation. Conclusions: PROPESS significantly reduced CS rates and increased delivery rates 24 h after the initial insertion in primiparas with unruptured membranes compared to mechanical dilatation. However, failure to respond to PROPESS resulted in an overall longer delivery time than that of the conventional mechanical dilation group;therefore, identifying predictors of response to PROPESS is necessary.

关键词： PROPESS labor induction Primiparas Cervical Ripening Unruptured Membranes

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