title: Labor induction in preeclampsia: is misoprostol more effective than dinoprostone?
abstract: OBJECTIVE
  To compare the efficacy of vaginal misoprostol versus dinoprostone for induction of labor (IOL) in patients with preeclampsia according to the WHO criteria.
  
  
  METHODS
  Ninety-eight patients were retrospectively analyzed. A total of 47 patients received 3 mg dinoprostone suppositories every 6 h (max. 6 mg/24 h) whereas 51 patients in the misoprostol group received either 50 mug misoprostol vaginally every 12 h, or 25 mug every 6 h (max. 100 mug/24 h). Primary outcomes were vaginal delivery within 24 and 48 h, respectively.
  
  
  RESULTS
  The probability of delivering within 48 h was more than three-fold higher in the misoprostol than in the dinoprostone group: odds ratio (OR)=3.48; 95% confidence interval (CI) 1.24, 10.30, whereas no significant difference was observed within 24 h (P=0.34). No correlation was seen between a ripe cervix prior to IOL and delivery within 24/48 h (P=0.33 and P=1.0, respectively). More cesarean sections were performed in the dinoprostone group due to failed IOL (P=0.0009). No significant differences in adverse maternal outcome were observed between both study groups, whereas more neonates (12 vs. 6) of the dinoprostone group were admitted to the NICU (P=0.068).
  
  
  CONCLUSIONS
  This study suggests that misoprostol may have some advantages compared to dinoprostone, including improved efficacy and lower cost of the drug, even in cases of preeclampsia.
authors: Department of Obstetrics and Gynecology, University Hospital Basel, Switzerland.
authors: Olav
authors: O
authors: Lapaire
authors: Rosanna
authors: R
authors: Zanetti-Dällenbach
authors: Patrizia
authors: P
authors: Weber
authors: Irene
authors: I
authors: Hösli
authors: Wolfgang
authors: W
authors: Holzgreve
authors: Daniel
authors: D
authors: Surbek
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D015232:Dinoprostone / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007751:Labor, Induced; D008499:Medical Records; D016595:Misoprostol / Q000008:administration & dosage / Q000627:therapeutic use*; D010120:Oxytocics / Q000008:administration & dosage / Q000627:therapeutic use*; D011225:Pre-Eclampsia; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone