title: [Efficacy of dinoprostone and misoprostol for labor induction in nulliparous women].
abstract: OBJECTIVE
  to determine the efficacy and safety of dinoprostone and misoprostol for the induction of vaginal childbirth, with or without the use of oxytocin in nulliparous women.
  
  
  METHODS
  in this retrospective observational study, 238 patients were subjected to the induction of delivery from January 2008 to February 2010 with the use of misoprostol 25 mcg by the vaginal route or a pessary containing 10 mg of dinoprostone. A total of 184 patients were selected, with the following characteristics: nulliparous, gestational age of 37-42 weeks, singleton pregnancies, cephalic presentation, intact membranes, and Bishop score < 3. Obstetric and neonatal data were analyzed and compared between groups. The Student t-test, chi-square test and Fisher's exact test were used for statistical analysis, with the level of significance set at p<0.05.
  
  
  RESULTS
  the rate of vaginal childbirth did not differ significantly in patients who used misoprostol and dinoprostone (43.2% versus 50%; p = 0.35, respectively). The ripening of cervix was higher in the group treated with misoprostol (87.3% versus 75.6%, p=0.04). The use of oxytocin was necessary in 58.8% of the misoprostol group and 57.3% in the dinoprostone group after the ripening of cervix. Failed induction was the primary indication of caesarean section delivery in both groups, with no significant difference between them. Fetal and maternal adverse events, such as tachysystole and Apgar scores were similar.
  
  
  CONCLUSIONS
  dinoprostone and misoprostol are both effective for vaginal childbirth induction, although they need to be combined with oxytocin. They showed a similar safety profile, with misoprostol being more efficient regarding cervical ripening.
authors.affiliation: Serviço de Obstetrícia, Hospital Maternidade Leonor Mendes de Barros, São Paulo, SP, Brasil.
authors.forename: Tenilson Amaral
authors.initials: TA
authors.lastname: Oliveira
authors.forename: Elisa Matias Vieira de
authors.initials: EM
authors.lastname: Melo
authors.forename: Márcia Maria Auxiliadora de
authors.initials: MM
authors.lastname: Aquino
authors.forename: Corintio
authors.initials: C
authors.lastname: Mariani Neto
mesh_terms: D015232:Dinoprostone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007751:Labor, Induced; D016595:Misoprostol / Q000627:therapeutic use*; D010120:Oxytocics / Q000627:therapeutic use*; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone