Misoprostol and dinoprostone therapy for labor induction: a Doppler comparison of uterine and fetal hemodynamic effects.
OBJECTIVE
To compare the effect of misoprostol (PGE(1)) versus dinoprostone (PGE(2)) on blood flow in uteroplacental circulation during labor induction.


METHODS
Eighty-four women with indications for induction of labor were assigned to receive either misoprostol 50 microg per vagina every 4 h as needed or 0.5 mg doses of dinoprostone given intra-cervically every 6 h by means of a randomization table generated by computer. Doppler velocimetry of umbilical, uterine and arcuate arteries was performed immediately before and 2-3 h after the administration of misoprostol or dinoprostone. The SAS system was used to perform statistical analysis.


RESULTS
There were no significant changes of pulsatility index (PI), resistance index (RI) and systolic/diastolic (S/D) ratio in umbilical arteries after both prostaglandin compounds. Vaginal application of misoprostol significantly increased all ratios in arcuate artery and S/D ratio in uterine artery. Intra-cervically dinoprostone significantly increased PI, RI and S/D ratio in arcuate and uterine arteries.


CONCLUSIONS
Our results indicate that vaginal misoprostol and cervical dinoprostone administration increases uteroplacental resistance but does not affect umbilical blood flow. Misoprostol would be as safe and effective agent as dinoprostone for cervical ripening and labor induction.
Urban
Remigiusz
R
Department of Perinatology, Medical Academy of Bialystok, University Hospital, Sklodowska-Curie 24a, 15-276, Bialystok, Poland. urbanrem@amb.edu.pl
Lemancewicz
Adam
A
Urban
Jan
J
Skotnicki
Mariusz Z
MZ
Kretowska
Malgorzata
M
D001783:Blood Flow Velocity / Q000187:drug effects; D015232:Dinoprostone / Q000008:administration & dosage*; D005260:Female; D005333:Fetus / Q000098:blood supply* / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D021041:Placental Circulation / Q000187:drug effects* / Q000502:physiology; D011247:Pregnancy; D011273:Pregnancy, Prolonged; D011673:Pulsatile Flow / Q000187:drug effects; D012039:Regional Blood Flow / Q000187:drug effects; D014463:Ultrasonography; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000187:drug effects; D014655:Vascular Resistance / Q000187:drug effects
D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone