R Neiger1, P C Greaves. 1. Department of Obstetrics and Gynecology, University of Tennessee Medical Center, Knoxville Unit, 1924 Alcoa Hwy., Knoxville, TN 37920, USA.
Abstract
OBJECTIVE: To compare the efficacy of intravaginal misoprostol (Cytotec) to intracervical dinoprostone (Prepidil) for pre-induction cervical ripening. METHODS:Sixty-one patients admitted for induction of labor, whose cervices were unfavorable (Bishop score: 4), were randomly assigned to either intravaginal placement of a 50 micrograms misoprostol tablet or intracervical administration of dinoprostone gel. RESULTS: Eighteen women (56%) in the misoprostol group and five (17%) in the dinoprostone group achieved cervical ripening within 12 hours (P = 0.007). Fewer doses of misoprostol were required to achieve cervical ripening, and the interval from induction of labor to delivery was shorter in the misoprostol group. Sixteen patients (50%) in the misoprostol group required oxytocin, whereas 26 (90%) in the dinoprostone group required oxytocin augmentation (P = 0.008). There was no significant difference in mode of delivery or neonatal outcome between the two groups. CONCLUSION:Vaginal misoprostol appears to be a more effective cervical ripening agent than cervical dinoprostone.
RCT Entities:
OBJECTIVE: To compare the efficacy of intravaginal misoprostol (Cytotec) to intracervical dinoprostone (Prepidil) for pre-induction cervical ripening. METHODS: Sixty-one patients admitted for induction of labor, whose cervices were unfavorable (Bishop score: 4), were randomly assigned to either intravaginal placement of a 50 micrograms misoprostol tablet or intracervical administration of dinoprostone gel. RESULTS: Eighteen women (56%) in the misoprostol group and five (17%) in the dinoprostone group achieved cervical ripening within 12 hours (P = 0.007). Fewer doses of misoprostol were required to achieve cervical ripening, and the interval from induction of labor to delivery was shorter in the misoprostol group. Sixteen patients (50%) in the misoprostol group required oxytocin, whereas 26 (90%) in the dinoprostone group required oxytocin augmentation (P = 0.008). There was no significant difference in mode of delivery or neonatal outcome between the two groups. CONCLUSION: Vaginal misoprostol appears to be a more effective cervical ripening agent than cervical dinoprostone.
Authors: Gabriel Arteaga-Troncoso; Aide E Chacon-Calderon; Francisco J Martinez-Herrera; Sylvia G Cruz-Nuñez; Marcela Lopez-Hurtado; Aurora Belmont-Gomez; Alberto M Guzman-Grenfell; Blanca E Farfan-Labonne; Carlos J Neri-Méndez; Francisco Zea-Prado; Fernando M Guerra-Infante Journal: PLoS One Date: 2019-11-21 Impact factor: 3.240