Initial clinical experience with a misoprostol vaginal insert in comparison with a dinoprostone insert for inducing labor

Mayer, RB; Oppelt, Peter; Shebl, Omar; Pömer, J; Allerstorfer, C; Weiss, Christoph

doi:10.1016/j.ejogrb.2016.03.008

Cited by 23 publications

(38 citation statements)

References 7 publications

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“…Other authors report comparable results [7,16,18,21]. In our clinic the study yields a vaginal delivery rate within 12 hours equal to 43.28% and within 24 hours equal to 83.58%.…”

Section: %supporting

confidence: 72%

“…Many authors regard the pre-induction with misoprostol as a very effective method in case of premature rupture of membranes (PROM) [25]. In the study of Mayer et al PROM was the second most common indication for the pre-induction with misoprostol [16]. In contrast, in our clinic such indication was made in 2% of cases only.…”

Section: Discussioncontrasting

confidence: 47%

“…In our study we recorded only 2% of cases with tachysystoly, same for hyperstimulation. This is a very low proportion compared to literature, where such rate was reported to reach 13% to 53% of pregnancies [3,15,16,19]. Abnormalities of cardiotocographic tracing were recorded in 43% of cases but less than half of them required caesarean section.…”

Section: %mentioning

confidence: 50%

“…The literature is rich is articles that compare and assess the effectiveness and safety of pre-induction methods involving prostaglandins such as dinoprostone gel and vaginal insert or misoprostol in form of tablets or inserts [7,[15][16][17][18][19]. Misoprostol tablets are registered in Europe for the prevention and treatment of gastric ulcers only.…”

Section: Discussionmentioning

confidence: 99%

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Obstetric outcomes of pre-induction of labor with a 200 μg misoprostol vaginal insert

et al. 2017

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Objectives: Labor induction is indicated in 20% to 40% of pregnancies. Over half of pregnancies qualified for the induction of labor require stimulation of the cervix to ripen. The drug used increasingly more often in pre-induction is the PGE-1 prostaglandin analog -misoprostol 200 μg. Material and methods:The study includes a total of 100 patients qualified for labor pre-induction with Misodel® (misoprostol 200 μg vaginal insert). The study group comprises two subgroups: primigravidas and multiparas. Assessments included: indications for labor pre-induction, time from Misodel application to delivery, caesarean section rate and indications, duration of first and second stage of labor, rate of vaginal deliveries, need for oxytocin or fenoterol administration side effects and newborn condition. Results:The most common indication for labor induction was gestational diabetes and pregnancy past term. The average time to vaginal delivery was 14 h 45 min, time to the onset of active phase of labor -11 h 45 min, time to membranes' rupture -15 h, time to vaginal delivery -14 h 18 min. The times of multiparas were significantly shorter. The rate of vaginal deliveries within 12 hours amounted to 42.42%, while within 24 hours it reached 83.33%. The overall caesarean section rate was 33%. The most common indication for caesarean section was the risk of intrauterine hypoxia. Tachysystole and hyperstimulation was observed in 4% of cases, while abnormalities in the cardiotocographic tracing in 43%. Conclusions:Misodel is an effective method for labor pre-induction, without affecting the caesarean section rate and has no adverse effect on the newborn condition.

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“…Other authors report comparable results [7,16,18,21]. In our clinic the study yields a vaginal delivery rate within 12 hours equal to 43.28% and within 24 hours equal to 83.58%.…”

Section: %supporting

confidence: 72%

Section: Discussioncontrasting

confidence: 47%

Section: %mentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

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Obstetric outcomes of pre-induction of labor with a 200 μg misoprostol vaginal insert

et al. 2017

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“…A recent multicenter randomized trial comparing a 200-mcg misoprostol vaginal insert with a 10-mg dinoprostone vaginal insert confirmed a higher risk of tachysystole in women receiving vaginal misoprostol [4]. Conversely, higher rate of tachysystole was not observed in a retrospective cohort study comparing a misoprostol vaginal insert with a dinoprostone vaginal insert, though tocolysis was carried out more often in the misoprostol group [5].…”

Section: Introductionmentioning

confidence: 94%

Efficacy of sublingual misoprostol for induction of labor at term and post term according to parity and membrane integrity: a prospective observational study

Brusati¹,

Brembilla²,

Cirillo³

et al. 2016

The Journal of Maternal-Fetal & Neonatal Medicine

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Clinical experience with misoprostol vaginal insert for induction of labor: a prospective clinical observational study

Neophytou

Hars²,

Freudenberg

et al. 2018

Arch Gynecol Obstet

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PurposeTo provide real-world evidence using misoprostol vaginal insert (MVI) for induction of labor in nulliparous and parous women at two German Level I Centers in a prospective observational study.MethodsBetween 1 August 2014 and 1 October 2015, eligible pregnant women (≥ 36 + 0 weeks of gestation) requiring labor induction were treated with MVI. Endpoints included time to and mode of delivery rates of tocolysis use, tachysystole, uterine hypertonus or uterine hyperstimulation syndrome and newborn outcomes.ResultsOf the 354 women enrolled, 68.9% (244/354) achieved vaginal delivery (nulliparous, 139/232 [59.9%]; parous 105/122 [86.1%]; p < 0.001). Median time from MVI administration to vaginal delivery was 14.0 h (nulliparous, 14.5 h; parous, 11.9 h; p < 0.001). A total of 205/244 (84.0%) and 228/244 (93.4%) women achieved a vaginal delivery within 24 h and 30 h, respectively. The most common indications for cesarean delivery were pathologic cardiotocography (nulliparous, 41/232 [17.4%]; parous, 13/122 [10.7%]; p = 0.081) and arrested labor (dilation or descent; nulliparous, 45/232 [19.4%], parous, 3/122 [2.5%]; p ≤ 0.001). A total of 24.3% of women experienced uterine tachysystole and 9.6% experienced uterine tachysystole with fetal heart rate involvement, neither of which were significantly different for nulliparous and parous women. In total, 42/345 (12.2%) of the neonates had an arterial pH < 7.15 and 12/345 3.5% had a 5-min Apgar score ≤ 7.ConclusionWhen clinically indicated, MVI was efficient and safe for induction of labor in women with an unfavorable cervix. Women, however, should be counseled regarding the risk of uterine tachysystole prior to labor induction with MVI.

show abstract

Initial clinical experience with a misoprostol vaginal insert in comparison with a dinoprostone insert for inducing labor

Cited by 23 publications

References 7 publications

Obstetric outcomes of pre-induction of labor with a 200 μg misoprostol vaginal insert

Obstetric outcomes of pre-induction of labor with a 200 μg misoprostol vaginal insert

Efficacy of sublingual misoprostol for induction of labor at term and post term according to parity and membrane integrity: a prospective observational study

Clinical experience with misoprostol vaginal insert for induction of labor: a prospective clinical observational study

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