A comparison of obstetrical outcomes and costs between misoprostol and dinoprostone for induction of labor

K, Nadia Bennett; Park, H; Cioffi, Joseph; Calixte, Rose; Vintzileos, Anthony M.

doi:10.3109/14767058.2016.1142965

Cited by 12 publications

(10 citation statements)

References 15 publications

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“…The studies concur that the risk of caesarean delivery does not differ, regardless of the dose. One frequent criticism of misoprostol is the greater risk of hyperstimulation resulting in fetal heart rate abnormalities, which we did not find in our study . This may be explained by the low doses of misoprostol (25 μg) used by most of the maternity units, but also by possible under‐reporting of this hyperstimulation (1%‐6% in the MEDIP study versus 10%‐20% in most studies) .…”

Section: Commentcontrasting

confidence: 73%

“…One frequent criticism of misoprostol is the greater risk of hyperstimulation resulting in fetal heart rate abnormalities, which we did not find in our study. 11,18,[32][33][34] Finally, interest in cervical ripening with balloon catheter has grown in recent years in French practices. 8,17 Professionals use it especially in women with previous caesareans or to improve fetal tolerance, because it mechanically ripens the cervix without causing contractions.…”

Section: Discussionmentioning

confidence: 99%

“…8,[15][16][17] To our knowledge, a single observational study, conducted in the United States and published in 2016, has compared these methods in current practice. 18 This comparison of 331 women found that the cost-effectiveness of misoprostol as a 50-μg vaginal tablet was better than that of the dinoprostone pessary. It was, however, a single-centre retrospective study with a method that limited its ability to take confounding factors into account.…”

Section: Data From Declarative Surveys About Maternity Units Practicesmentioning

confidence: 99%

“…Data from declarative surveys about maternity units practices showed that the most common ripening methods were used in very diverse ways, but they could not compared the methods at the individual level . To our knowledge, a single observational study, conducted in the United States and published in 2016, has compared these methods in current practice . This comparison of 331 women found that the cost‐effectiveness of misoprostol as a 50‐μg vaginal tablet was better than that of the dinoprostone pessary.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of effectiveness and safety of cervical ripening methods for induction of labour: A population‐based study using coarsened exact matching

Blanc-Petitjean

Carbonne

Deneux‐Tharaux

et al. 2019

Paediatric Perinatal Epid

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Background There is no consensus about the ideal cervical ripening method to use for induction of labour. Objective To compare in current practice the effectiveness and safety of four cervical ripening methods. Methods We performed a matched comparative study using data from the MEDIP prospective population‐based cohort conducted during one month in 2015 in all maternity units of seven French perinatal networks (3042 consecutive women with a live fetus and induction of labour). We analysed 1671 women with singleton cephalic fetus, unscarred uterus, and bishop score <7. Dinoprostone vaginal pessary (reference) was compared to dinoprostone vaginal gel, misoprostol vaginal tablet, and balloon catheter. Effectiveness outcomes were the need for more than one induction agent, oxytocin use, failure to achieve vaginal delivery within 24 hours (VD < 24 hours), and caesarean delivery. Safety outcomes were meconium‐stained amniotic fluid, uterine hyperstimulation, NICU admission, and post‐partum haemorrhage. Coarsened exact matching was used to balance confounders among the groups. Outcomes were compared using multivariable logistic regression models. Results Compared to the dinoprostone pessary (N = 1142, 68.3%), dinoprostone gel (N = 335, 20.1%) was associated with less failure to achieve VD < 24 hours (adjusted OR 0.66, 95% CI 0.47, 0.91). Misoprostol (N = 103, 6.2%) was associated with less need of more than one induction agent (aOR 0.56, 95% CI 0.34, 0.92) and less oxytocin use (aOR 0.60, 95% CI 0.37, 0.99). The balloon catheter (N = 91, 5.4%) was associated with more failure to achieve VD < 24 hours (aOR 2.62, 95% CI 1.37, 5.01), more caesarean delivery (aOR 1.84, 95% CI 1.09, 3.08), and less meconium‐stained amniotic fluid (aOR 0.12, 95% CI 0.02, 0.70). Uterine hyperstimulation rates seemed lower with the balloon catheter (1.2% vs 4.2% for the pessary). Conclusions In current practice, no cervical ripening method appears clearly superior to the others considering all effectiveness and safety outcomes.

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Section: Commentcontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Data From Declarative Surveys About Maternity Units Practicesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of effectiveness and safety of cervical ripening methods for induction of labour: A population‐based study using coarsened exact matching

Blanc-Petitjean

Carbonne

Deneux‐Tharaux

et al. 2019

Paediatric Perinatal Epid

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“…Misoprostol can be used in different ways, including oral, vaginal, sublingual, buccal, titrated solution and rectal (4)(5)(6)(7)(8)(9)(10)(11). Prostaglandin E 2 (12)(13)(14)(15)(16), prostaglandin F 2 α (12), mifepristone (17), nitric oxide donors (18,19), corticosteroids (20)(21)(22), propranolol (23), estrogen (24), hyaluronidase (25), and relaxin (26) are among the pharmaceutical agents which have been used for cervical ripening and induction of labor.…”

Section: Introductionmentioning

confidence: 99%

A comparison between induction of labor with 3 methods of titrated oral misoprostol, constant dose of oral misoprostol and Foley catheter with extra amniotic saline infusion (EASI), in women with unfavorable cervix

Kashanian¹,

Bahasadri²,

Dehcordi³

et al. 2019

Med. J. Islam. Republ. Iran

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Background: Different methods of cervical ripening and induction of labor have been used in the cases of unfavorable cervix with different levels of success, but no method has been found to be the best option. The purpose of the present study was to find the effects and side effects of three different methods of cervical ripening and induction of labor. These three methods were oral titrated misoprostol, constant dose of oral misoprostol and Foley catheter with extra-amniotic saline infusion. Methods: This clinical trial was performed on women with unfavorable cervix who had been admitted in Akbarabadi Teaching Hospital for induction of labor and had bishop score of less than six; between March 2014-March 2015. The eligible women were assigned into three groups. In titrated oral misoprostol group (n=33), titrated solution of misoprostol, and in oral misoprostol group (n=33), 50µg oral misoprostol every four hours and in Foley catheter group (n=50), Foley catheter with extra-amniotic saline infusion were administered. The main outcome was the number of vaginal deliveries during the first 24 hours. In addition, number of cesarean deliveries and adverse effects were compared between the three groups. The obtained data were analyzed using SPSS 18 software. Data analysis was performed according to the intention to treat principle. Chi-square test, Fisher Exact test, Student ttest, and Mann-Whitney U test, were used for comparing data. P-value≤0.05 was considered statistically significant. Results: The three groups did not have any significant difference according to maternal age, gestational age at the time of admission, gravidity, parity, and primary Bishop Score. There was no significant difference between the three groups for the main outcome, which was vaginal delivery during the first 24 hours (p=0.887). There was no significant difference between the three groups according to hypertonicity, uterine hyperstimulation, meconium passage, non-reassuring fetal heart rate, neonatal Apgar score in minutes one and 5, and mean duration of beginning the intervention up to delivery. However, uterine tachysystole and NICU admission were more in the group to whom the titrated solution of misoprostol was administered (p=0.002 and p=0.037 respectively). The number of cesarean deliveries due to failure to progress was higher in the EASI group. However, EASI group showed the least number of none-reassuring fetal heart rate between the three groups. Meconium passage was more in the titrated misoprostol group, but the difference was not significant. Conclusion: All three methods are appropriate methods for induction of labor in the cases of unfavorable cervix; and choosing each method depends on the expertise of labor staff, accessibility to the medications, cost, and taking care for monitoring the patients and adverse effects.

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Cost‐effectiveness analysis of vaginal misoprostol versus dinoprostone pessary: A non‐inferiority large randomized controlled trial in France

Mounié

Costa

Gaudineau

et al. 2021

Intl J Gynecology & Obste

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Induction of labor (IOL) is a common procedure, performed for approximately 40% of nulliparous and 30% of multiparous women. 1 It is recommended for women with a medical indication and may be justified after 39 weeks of gestation to improve the safety for mothers as well as infants. 2,3 At present, the drug of reference for induction is slow-release dinoprostone (PGE2). 4 In comparison, misoprostol, a synthetic analog of prostaglandin E1 (PGE1) is a less expensive, thermostable,

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A comparison of obstetrical outcomes and costs between misoprostol and dinoprostone for induction of labor

Abstract: Single-dose misoprostol is more efficient in IOL at term with respect to L&D utilization and cost and its use is not associated with increased adverse obstetrical outcomes.

Cited by 12 publications

References 15 publications

Comparison of effectiveness and safety of cervical ripening methods for induction of labour: A population‐based study using coarsened exact matching

Comparison of effectiveness and safety of cervical ripening methods for induction of labour: A population‐based study using coarsened exact matching

A comparison between induction of labor with 3 methods of titrated oral misoprostol, constant dose of oral misoprostol and Foley catheter with extra amniotic saline infusion (EASI), in women with unfavorable cervix

Cost‐effectiveness analysis of vaginal misoprostol versus dinoprostone pessary: A non‐inferiority large randomized controlled trial in France

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