Induction of Labor using Misoprostol in a Tertiary Hospital in the Southeast of Brazil

Abstract

Keywords► labor induction ► misoprostol ► oxytocin ► cesarean sections AbstractPurpose To assess cases of labor induction with vaginal 25-µg tablets of misoprostol and maternal outcomes in a tertiary hospital in southeastern Brazil. Methods This was a retrospective cohort study of 412 pregnant women with indication for labor induction. Labor induction was performed with vaginal 25-µg tablets of misoprostol in pregnant women with Bishop scores < 6. Stepwise regression analysis was used to identify the factors present at the beginning of induction that could be used as predictors of successful labor induction. Results A total of 69% of the pregnant women who underwent labor induction progressed to vaginal delivery, and 31% of the women progressed to cesarean section. One or two misoprostol tablets were used in 244 patients (59.2%). Of the 412 patients, 197 (47.8%) required oxytocin later on in the labor process, after induction with misoprostol. The stepwise regression analysis showed that only Bishop scores of 4 and 5 and previous vaginal delivery were independent factors with statistical significance in the prediction of successful vaginal labor induction (β ¼ 0.23, p < 0.001, for a Bishop score of 4 and 5, and β ¼ 0.22, p < 0.001, for previous vaginal delivery). Conclusion Higher Bishop scores and previous vaginal delivery were the best predictors of successful labor induction with vaginal 25-µg tablets of misoprostol. ResumoObjetivo Avaliar os casos de indução do trabalho de parto com misoprostol 25 mcg por via vaginal e seus desfechos maternos em um hospital terciário do Sudeste do Brasil.

Misoprostol Induction of Labor in Multipara Pregnant Women: A Mini-Survey for Predictors of Outcome.

“…During the observation period, irrespective of misoprostol dose; 530 women had VD for a rate of 82.3%, of which only 168 women required instrumental assistance and 114 women (17.7%) had CS for varied indications. These figures are superior to that reported by Mbaluka et al (21) who reported an overall induction success rates with misoprostol versus oxytocin were 81% versus 83%, respectively and Silva et al (22) who reported an IOL trial success of 69% using vaginal 25-µg misoprostol tablets, while 31% of the women progressed to CS.…”

“…Recently, Al-Adwy et al (36) found posterior cervical angle of >99.5° yielded the best accuracy in predicting successful IOL compared with the cervical length and Bishop score. On contrary to these data, Silva et al (22) and Garba et al (23) found higher Bishop scores were the best predictors of successful misoprostol IOL. However, Levine et al (3) documented that modified Bishop score was significantly associated with CS.…”

“…As regards the predictability of parity for IOL outcome, Silva et al (22) found previous VD was the best predictor of successful IOL with MVI and Garba et al (23) reported that high parity was found to be associated with IOL success. Moreover, Navve et al (28) reported that IOL in multiparous women is safe and successful regardless of the initial BS and Prado et al (35) found increased parity, increases the chance of achieving a successful VD.…”

Prognostic Factors of Induction of Labor with Misoprostol at CHUD/B in Parakou, Benin in 2016

“…This frequency is by far less than those found in studies conducted in France and the USA [4] [5] on the one hand and in Brazil (59.2%) and Tunisia [6] [7] on the other hand. In general, the frequency of induction varies widely from a region to another and even from a health care institution to another [4] [7].…”

“…Thus, the frequency of induction is generally higher in western [8]. This difference between developed countries and developing ones as regards induction of labor could be accounted for by a broadening of indications especially the indications on personal grounds [6]. Clinically, the two groups differed from each other by Bishop score which was unfavorable in all cases and 98.48% favorable for the control-group.…”