Influence of misoprostol or prostaglandin E(2) for induction of labor on the incidence of pathological CTG tracing: a randomized trial

Eur J Obstet Gynecol Reprod Biol. 2004 Sep 10;116(1):34-8. doi: 10.1016/j.ejogrb.2004.01.038.

Abstract

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.

Study design: 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).

Conclusion: Misoprostol shortened the induction-to-delivery interval, but is associated with a higher incidence of abnormal CTG than prostaglandin E(2).

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cardiotocography*
  • Cervical Ripening / drug effects
  • Dinoprostone / adverse effects*
  • Female
  • Fetal Diseases / chemically induced*
  • Fetal Diseases / diagnosis
  • Fetal Diseases / epidemiology
  • Heart Rate, Fetal / drug effects
  • Humans
  • Incidence
  • Labor, Induced / methods*
  • Misoprostol / adverse effects*
  • Oxytocics / adverse effects*
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Trimester, Third
  • Time Factors
  • Treatment Outcome

Substances

  • Oxytocics
  • Misoprostol
  • Dinoprostone