Influence of misoprostol or prostaglandin E(2) for induction of labor on the incidence of pathological CTG tracing: a randomized trial.
OBJECTIVE
To compare the efficacy and safety of misoprostol (prostaglandin E(1) (PGE(1))) with dinoprostone (prostaglandin E(2) (PGE(2))) for third trimester cervical ripening and labor induction.


METHODS
Patients requiring induction of labor were randomly assigned to receive either 50 microg of intravaginal misoprostol every 4 h or 0.5 mg of intracervical dinoprostone gel every 6 h. Eligibility criteria included gestation = 36 weeks. Primary outcome was the time interval from induction to delivery; secondary outcomes were mode of delivery, perinatal outcome, and interpretation of cardiotocogram (CTG) records.


RESULTS
Two hundred women were randomly enrolled to receive either misoprostol (n = 100) or dinoprostone (n = 100). Time induction-to-delivery at 12, 24 and 48 h and the need for oxytocin were reduced with misoprostol (P < 0.05). Pathological CTG tracing according to FIGO and Melchior scores were more frequent in the misoprostol-treated group (P < 0.001).


CONCLUSIONS
Misoprostol shortened the induction-to-delivery interval, but is associated with a higher incidence of abnormal CTG than prostaglandin E(2).
Department of Obstetrics and Gynecology, Lausanne University Hospital, Rue du Bugnon 30, 1010 Lausanne, Switzerland. alexandre.megalo@chuv.hospvd.ch
Alexandre
A
Megalo
Patrick
P
Petignat
Patrick
P
Hohlfeld
D000328:Adult; D015148:Cardiotocography; D020070:Cervical Ripening / Q000187:drug effects; D015232:Dinoprostone / Q000009:adverse effects*; D005260:Female; D005315:Fetal Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D015994:Incidence; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000009:adverse effects*; D010120:Oxytocics / Q000009:adverse effects*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D013997:Time Factors; D016896:Treatment Outcome
D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone