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Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol

  • Martina Kreft , Franziska Krähenmann , Malgorzata Roos , Juozas Kurmanavicius , Roland Zimmermann and Nicole Ochsenbein-Kölble EMAIL logo
Published/Copyright: March 14, 2014

Abstract

Aim: To compare the efficacy and safety of two misoprostol dosing regimens for induction of labour in primiparous (1P) and multiparous (>1P) women.

Methods: Retrospective study of induction of labour using vaginal misoprostol 25 μg vs. 50 μg every 6 h in 942 women at a tertiary centre. The main outcome variables are induction-to-delivery interval, latency period duration, vaginal delivery within 24 h, and maternal and foetal safety outcome.

Results: With the 50 μg regimen, induction-to-delivery intervals were significantly shorter: 18.4 h vs. 24.6 h (1P) and 14 h vs. 17.9 h (>1P), as was latency period duration (by 5.4 and 4 h, respectively). Vaginal delivery within 24 h was significantly more frequent, as were non-reassuring foetal heart rate (1P: 20% vs. 14%) and tachysystole (1P: 31% vs. 11%; >1P: 21% vs. 7%). No uterine rupture was reported. Neonatal outcomes were similar except for significantly more frequent infant referral to neonatal intensive care in the >1P group receiving the 50 μg regimen (11% vs. 4%).

Conclusion: Vaginal misoprostol 25 μg seems to maintain efficacy with more acceptable maternal and neonatal safety. As induction of labour is an off-label use for misoprostol, safety should be prioritised with the lower dosage regimen despite the longer induction-to-delivery interval.


Corresponding author: Nicole Ochsenbein-Kölble, MD, Obstetric Research Unit, Department of Obstetrics, University Hospital Zurich, Frauenklinikstr. 10, CH-8091 Zurich, Switzerland, Tel.: +41-1-255-5134, Fax: +41-1-255-4430, E-mail:

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2013-8-13
Accepted: 2014-1-17
Published Online: 2014-3-14
Published in Print: 2014-9-1

©2014 by De Gruyter

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