Comparison between vaginal misoprostol and cervical dinoprostone for cervical ripening and labor induction.
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.


CONCLUSIONS
Vaginal misoprostol appears to be a more effective cervical ripening agent than cervical dinoprostone.
Neiger
R
R
Department of Obstetrics and Gynecology, University of Tennessee Medical Center, Knoxville Unit, 1924 Alcoa Hwy., Knoxville, TN 37920, USA.
Greaves
P C
PC
D000282:Administration, Intravaginal; D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects*; D015232:Dinoprostone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007751:Labor, Induced; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D011247:Pregnancy
D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone