Active management of term prelabour rupture of membranes with oral misoprostol

Shetty, Ashalatha; Stewart, K. S.; Stewart, Gayle M.; Rice, Pat; Danielian, PJ; Templeton, Alexander Allan

doi:10.1046/j.1471-0528.2002.02082.x

Cited by 28 publications

(11 citation statements)

References 17 publications

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“…In 1996, Ngai et al [47] investigated the effectiveness of oral misoprostol as a cervical-priming agent for patients presenting with prelabor rupture of membranes at term and suggested that oral misoprostol is an effective agent for this group of patients. Similar results were published by Sanchez-Ramos et al [27] in 1997 and Shetty et al [48] in 2002. The latter concluded that active management with oral misoprostol resulted in more women going into labor and delivering within 24 h of prelabor rupture of membranes with no increase in maternal or neonatal complications.…”

Section: Labor Induction At Termsupporting

confidence: 88%

Misoprostol for labor induction in term pregnancy

Surbek

2007

Eur Clinics Obstet Gynaecol

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Misoprostol has been used off-label for labor induction for many years. A large number of randomized controlled studies have assessed the efficacy and safety of misoprostol in different dose ranges between 10 and 100 mcg, with different dose intervals and different administration routes including oral, intravaginal, rectal, sublingual, and buccal administration. Currently, registration trials are underway, and misoprostol for registered indication of labor induction might be available in several European countries in the near future. Meanwhile, guidelines for off-label use should be provided by authorities or OB/GYN associations.

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Section: Labor Induction At Termsupporting

confidence: 88%

Misoprostol for labor induction in term pregnancy

Surbek

2007

Eur Clinics Obstet Gynaecol

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“…These studies are summarized in Table 3. 18,20,[28][29][30][31][32][33][34][35][36][37][38] In 1996, the first documented study of oral misoprostol use for women with PROM evaluated a 200 mcg dose for cervical ripening compared to placebo prior to administration of oxytocin for induction of labor. 28 Improvements in Bishop score (8.4 vs 5.0; 95% CI, 2.2-4.1; P Ͻ .05), lower rates of oxytocin use (13% vs 51%; 95% CI, 2.2-4.1; P Ͻ .001), and a shorter interval from PROM to birth (7.5 [6.0] vs 16.2 [3.9]; 95% CI, 6.1-11.3; P Ͻ .01) were noted.…”

Section: Management Of Prelabor Rupture Of Membranes With Orally Admimentioning

confidence: 99%

“…This study showed a longer interval from induction to birth in the misoprostol group (720 min [382] vs 501 min [389]; P = .007), equal rates of maternal satisfaction, and no differences in rates of uterine tachysystole or maternal or neonatal outcomes. 29 In a study by Shetty et al (2002), women with PROM (N = 61) were treated with orally administered misoprostol every 4 hours, up to 5 doses, followed by oxytocin if necessary; or expectant management up to 24 hours, followed by application of vaginally administered prostaglandin E2 gel if women had an unfavorable cervix; or oxytocin with a favorable cervix if not already in active labor. When uterine contractility suggested active labor for women receiving oral misoprostol, a sterile vaginal examination was performed and the women were transferred to the labor ward for management of labor or oxytocin augmentation, as indicated.…”

Section: Management Of Prelabor Rupture Of Membranes With Orally Admimentioning

confidence: 99%

“…The authors noted that there was no reduction in number of sterile vaginal examinations performed on women receiving induction of labor with orally administered misoprostol, although they argue that the decision to administer subsequent doses of misoprostol for management of induction of labor could be made based on uterine contractility alone, thus avoiding unnecessary cervical examinations. 32 The MisoPROM study is one of the larger trials on use of misoprostol by women with PROM. 35 In this nonblinded RCT, women with PROM (N = 305) were assigned to receive either 100 mcg orally administered misoprostol every 6 hours for a maximum of 2 doses, and then augmented with oxytocin, as necessary; or immediate induction of labor with oxytocin.…”

Section: Management Of Prelabor Rupture Of Membranes With Orally Admimentioning

confidence: 99%

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Orally Administered Misoprostol for Induction of Labor with Prelabor Rupture of Membranes at Term

Radoff¹

2014

J Midwife Womens Health

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Prelabor rupture of membranes (PROM) occurs in approximately 8% to 10% of women with term pregnancies. The management of PROM continues to be controversial. Approaches include expectant management and immediate induction of labor. The use of orally administered misoprostol for the management of women with PROM may provide significant advantages when they choose immediate induction of labor. This literature review presents current evidence that supports the use of oral misoprostol for women with PROM, including the benefits of a decreased interval time from PROM to vaginal birth, good safety profile, and reductions in the use of oxytocin augmentation and epidural anesthesia. In addition to clinically proven benefits to women of oral misoprostol for PROM, it also has the potential to reduce chorioamnionitis by reducing the number of sterile vaginal examinations performed thereby reducing the risk of ascending bacteria. Women have also reported acceptability and satisfaction when using oral misoprostol for immediate induction of labor. This review of literature discusses what is known about the use of orally administered misoprostol for the management of term PROM and makes recommendations for clinical use.

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“…Active induction of labor soon after PROM reduces the risks of maternal and foetal sepsis 4 compared with conservative management, and is associated with a shorter interval from PROM to significant uterine contractions and delivery. 6 For the labour that is induced, the timing of the induction is controversial. Indeed, the decision to induce labour often depends more on the convenience of the physicians, nurses or midwives than on the actual time that elapsed after rupture of the membranes.…”

Section: Introductionmentioning

confidence: 99%

Pre-labour Rapture of Membrane at Term in Patients with an Unfavorable Cervix: Active verses Conservative Management

Afrooz

Faruq

Islam³

2017

Ibrahim card. med. j.

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Objective: The present quasi-experimental (comparative clinical trial) study was conducted to compare the outcome of active versus conservative management in patients with prelabour rupture of membrane (PROM) at term with an unfavourable cervix. Materials & Methods: The study was carried out at Gynae & Obstetrics Department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka over a period of 12 months from July 2009 to June 2010. Women admitted in the Obstetrics & Gynaecology Ward of BSMMU with pre-mature rupture of membrane (PROM) at term with unfavourable cervix was the study population. A total of 86 women with rupture of membranes at > 37 weeks of gestation with a single foetus in a cephalic presentation, Bishop's score below 6, absence of active labour, no history of previous uterine surgery, no contraindication to vaginal delivery, a normal cardiotocogram and an adequate pelvis on clinical pelvimetry were included in the study and divided into two groups – study group (who received 25 μg of misoprostol every 6 hours in the posterior fornix of the vagina to a maximum of 4 doses) and control (who received conservative treatment for 24 hours). Result: The result shows that the study and control groups were almost identical in terms of age (p = 0.058), parity (p = 0.812), H/O past abortion (p = 0.366). Majority (94.3%) of the patients in case group and 64.4% in control group took 24 or < 24 hours to deliver their babies. The mean interval between PROM and uterine contraction and that between ROM and delivery were significantly less in the study group than those in the control group (p < 0.001 and p < 0.001 respectively). About 63% of study group experienced significant uterine contractions after 1st dose, 23.3% after 2nd dose, 9.3% after 3rd dose and 4.7% after 4th dose of misoprostol, while none of the patients in control group experienced significant contraction during the same period (p < 0.001). Twenty two (50.6%) of controls needed oxytocin for induction as opposed to none in the study group. The need for oxytocin during labour in study group were significantly less (37.2%) than that in control (80.5%) (p= 0.024). The incidence of failed induction was even less in study group (11.6%) than that in control (44.2 %) (p = 0.001). Two (4.7%) patients in the study group developed uterine hyperstimulation, 2.3% uterine tachysystole and another 2.3% nausea/vomiting while none of patients in control group developed the same complications. One (2.3%) of the patients in study group experienced chorioamnionitis and 9.3% exhibited group-B streptococci in high vaginal swab culture. In contrast, 18.6% of the controls developed chorioamnionitis and 14% showed the presence of group-B streptococci in high vaginal swab. In terms of mode of delivery, normal vaginal delivery (NVD) occurred in 88.4% study group as compared to 53.5% of control group (p<0.001). There was no significant difference between the groups in terms of foetal distress (p= 0.747) and neonatal sepsis (p = 0.121). Over half of the patients in the both groups had a history of less than 4 vaginal examinations during labour. There was no significant differences between the groups with respect to Apgar score at 1 minute of birth, neonatal sepsis and foetal distress (p=0.063, p=0.121 and p=0.747 respectively). Conclusion: The study concluded that management of premature rupture of membrane with unfavourable cervix using vaginal misoprostol increases the rate of normal delivery thereby reducing the risk of caesarean section, while conservative management of premature rupture of membrane usually fails to augment normal delivery. So it is safer to give induction to women presenting with premature rupture of membrane with unfavourable cervix using vaginal misoprostol. Ibrahim Card Med J 2015; 5 (1&2): 35-39

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Active management of term prelabour rupture of membranes with oral misoprostol

Cited by 28 publications

References 17 publications

Misoprostol for labor induction in term pregnancy

Misoprostol for labor induction in term pregnancy

Orally Administered Misoprostol for Induction of Labor with Prelabor Rupture of Membranes at Term

Pre-labour Rapture of Membrane at Term in Patients with an Unfavorable Cervix: Active verses Conservative Management

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