title: Comparative study of titrated oral misoprostol solution and vaginal dinoprostone for labor induction at term pregnancy.
abstract: To evaluate effectiveness and safety of titrated oral misoprostol solution (OMS) in comparison with vaginal dinoprostone for cervix ripening and labor induction in term pregnant women.
  
  
  
  A multicenter randomized controlled trial of women with term singleton pregnancy with indications for labor induction; 481 participants were allocated to receive titrated OMS with different doses by hourly administration according to the procedure or insert vaginal dinoprostone for cervix ripening and labor induction to compare maternal outcomes including indication of labor induction, mode of outcome of delivery, maternal morbidity, and neonatal outcomes between two groups for evaluating the efficacy and safety of titrated oral misoprostol induction.
  
  
  
  Proportion of delivery within 12 h of titrated oral misoprostol is significantly less than vaginal dinoprostone (p = 0.03), but no difference of total vaginal delivery rate (p = 0.93); the mean time of first treatment to vaginal delivery was longer in OMS group (21.3 ± 14.5 h) compared with the vaginal dinoprostone group (15.7 ± 9.6 h). Although the proportion of cesarean section between the two groups showed no statistically significant difference, OMS group showed significantly lower frequency of uterine hyperstimulation, hypertonus, partus precipitatus and non-reassuring fetal heart rate than dinoprostone group. Neonatal outcomes were similar evaluating from Apgar score and NICU admission. Our study also showed that labor induction of women with cervix Bishop score ≤3 needed increased dosage of misoprostol solution.
  
  
  
  Titrated OMS is as effective as vaginal dinoprostone in labor induction for term pregnant women, with safer effect for its lower rate of adverse effect for women.
authors.affiliation: Department of Gynecology and Obstetrics, Affiliated Guangren Hospital of Xi'an Jiaotong University, No. 21, Jiefang Road, Xi'an, 710004, Shaanxi, China. 3137119239@qq.com.
authors.forename: Xiu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Gynecology and Obstetrics, Affiliated Guangren Hospital of Xi'an Jiaotong University, No. 21, Jiefang Road, Xi'an, 710004, Shaanxi, China.
authors.forename: Aijun
authors.initials: A
authors.lastname: Yang
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, No. 61, Jiankang Road, Xi'an, 710061, Shaanxi, China.
authors.forename: Qingyong
authors.initials: Q
authors.lastname: Ma
authors.affiliation: Department of Gynecology and Obstetrics, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, No. 61, Jiankang Road, Xi'an, 710061, Shaanxi, China.
authors.forename: Xuelan
authors.initials: X
authors.lastname: Li
authors.affiliation: Obstetric Department of Shannxi Province People Hospital, No. 42, Friendship Road, Xi'an, 710068, Shaanxi, China.
authors.forename: Li
authors.initials: L
authors.lastname: Qin
authors.affiliation: Obstetric Department of Maternal and Child Care Service Center of Northwest, No. 1616, Yanxiang Road, Xi'an, 710008, Shaanxi, China.
authors.forename: Tongqiang
authors.initials: T
authors.lastname: He
mesh_terms: D000282:Administration, Intravaginal; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects; D015232:Dinoprostone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D011247:Pregnancy
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone
keywords: Dinoprostone; Efficacy and safety; Labor induction; Titrated oral misoprostol