title: Induction of Labor in Women with Oligohydramnios: Misoprostol Compared with Prostaglandin E2.
abstract: ObjectiveTo compare perinatal outcomes in women with oligohydramnios and an unfavorable cervix undergoing labor induction with misoprostol to prostaglandin E2.Study DesignWe conducted a secondary analysis of women with oligohydramnios undergoing labor induction in the Consortium on Safe Labor study (2002-2008). Oligohydramnios was recorded in the medical chart. We evaluated perinatal outcomes. We limited the analysis to women with an unfavorable cervix defined by simplified Bishop score ≤ 4. Misoprostol was compared with prostaglandin E2. Women could have received oxytocin, underwent mechanical dilation, or had artificial rupture of membranes, but women who underwent induction with both misoprostol and prostaglandin E2 were excluded. We calculated adjusted odds ratios with 95% confidence intervals, controlling for maternal age, maternal body mass index (kg/m2), parity, and mechanical dilation.ResultsAmong women with oligohydramnios and an unfavorable cervix who underwent induction of labor, 141 (39.4%) received misoprostol and 217 (60.6%) received prostaglandin E2. There were no significant differences in cesarean delivery, chorioamnionitis, postpartum hemorrhage, transfusion, neonatal intensive care unit (NICU) admission, NICU stay > 72 hours, mechanical ventilation, and neonatal sepsis.ConclusionIn women with oligohydramnios and an unfavorable cervix, induction of labor with misoprostol was comparable to prostaglandin E2.
authors.affiliation: Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawakita
authors.affiliation: Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Grantz
authors.affiliation: Department of Obstetrics and Gynecology, MedStar Georgetown University Hospital, Washington, District of Columbia.
authors.forename: Helain J
authors.initials: HJ
authors.lastname: Landy
authors.affiliation: Department of Biostatistics and Epidemiology, MedStar Health Research Institute, Hyattsville, Maryland.
authors.forename: Chun-Chih
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Kominiarek
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D002585:Cesarean Section; D002821:Chorioamnionitis / Q000209:etiology; D015232:Dinoprostone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007751:Labor, Induced / Q000379:methods*; D007902:Length of Stay; D016595:Misoprostol / Q000627:therapeutic use*; D016104:Oligohydramnios / Q000628:therapy*; D010120:Oxytocics; D010343:Patient Admission; D006473:Postpartum Hemorrhage / Q000209:etiology; D011247:Pregnancy; D012121:Respiration, Artificial; D018805:Sepsis / Q000209:etiology; D055815:Young Adult
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone