A comparison of intermittent vaginal administration of two different doses of misoprostol suppositories with continuous dinoprostone for cervical ripening and labor induction.
OBJECTIVE
To compare the efficacy of a vaginal insert administering continuous dinoprostone with vaginal suppositories containing two different doses of misoprostol for cervical ripening and induction of labor.


METHODS
In this prospective, randomized, double-blinded study, 118 patients with indications for induction of labor and an unfavorable Bishop score were randomly assigned to receive either continuous dinoprostone, misoprostol 35-microg suppositories, or misoprostol 50-microg suppositories.


RESULTS
No significant differences were noted among the three groups in the change of Bishop score, induction of active labor or the time from initial treatment to delivery. Active labor occurred in roughly two-thirds of the patients in an average of about 5.7-6.7 h regardless of treatment assignment. When the two misoprostol groups were combined, a shorter interval from insertion to vaginal delivery was observed in the nulliparous women receiving misoprostol than those receiving continuous dinoprostone (21.3 vs. 27.2 h, p = 0.019). Except for the significantly lower incidence of tachysystole observed in the combined misoprostol group (3.8% vs. 15.4%, p = 0.036), there were no other significant differences between the groups in mode of delivery or in adverse maternal, fetal, or neonatal effects.


CONCLUSIONS
Misoprostol suppositories appeared to be as effective and safe as continuous dinoprostone in inducing cervical ripening in this sample.
Khoury
A N
AN
Department of Obstetrics and Gynecology, lnova Fairfax Hospital, Falls Church, Virginia 22042-3300, USA.
Zhou
Q P
QP
Gorenberg
D M
DM
Nies
B M
BM
Manley
G E
GE
Mecklenburg
F E
FE
D000282:Administration, Intravaginal; D001034:Apgar Score; D020070:Cervical Ripening / Q000187:drug effects*; D015232:Dinoprostone / Q000008:administration & dosage* / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007745:Labor Onset / Q000187:drug effects; D007751:Labor, Induced; D008297:Male; D016595:Misoprostol / Q000008:administration & dosage* / Q000627:therapeutic use*; D010120:Oxytocics / Q000008:administration & dosage* / Q000627:therapeutic use*; D010298:Parity; D010570:Pessaries; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D013997:Time Factors
D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone