Misoprostol vaginal insert and Foley catheter in labour induction — single center retrospective observational study of obstetrical outcome

Młodawski, Jakub; Mlodawska, Marta; Płusajska, Justyna; Jagoda, Galuszewska; Glijer, Kamila; Głuszek, Stanisław

doi:10.5603/gp.a2020.0118

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…It was found that both preinduction and epidural analgesia were more frequently performed in the group of patients whose uterine contractions were stimulated by oxytocin. An in-depth analysis of preinduction conducted by Mlodawski et al shows that women treated with misoprostol less frequently required stimulation with oxytocin during labor compared to women who were treated with a Foley catheter [ 20 ]. French researchers Girault et al showed that the determinants of abuse of augmentation of labor were, among others, epidural anesthesia [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Use and Effects of Augmentation of Labor with Oxytocin: A Single-Center, Retrospective, Case-Control Study of 4350 Women in Warsaw, Poland, 2015-2020

Bączek

Rychlewicz²,

Budner

et al. 2022

Med Sci Monit

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Background Although there have been some recent clinical trials on the effects of augmentation of labor with oxytocin, or augmentation of labor, there are no clinical guidelines to explain the variations in obstetric practice between countries and within countries. This retrospective case-control study from a single center in Warsaw, Poland aimed to evaluate the use and effects of augmentation of labor with oxytocin in 4350 women between 2015 and 2020. Material/Methods This was a single-center, retrospective, case-control study in which 29 455 cases were qualified for analysis. The study included the analysis of 2 groups: the study group consisted of 4382 patients who underwent stimulation of childbirth, and the control group consisted of 25 073 patients who did not undergo this obstetric procedure. Results Multivariate logistic regression analysis showed that the factors increasing the frequency of augmentation of labor were higher BMI ( P <0.05), preinduction ( P <0.05), epidural anesthesia ( P <0.05), and family present at birth ( P <0.05). Factors influencing reduction in the frequency of augmentation of labor were higher number of deliveries ( P <0.05), vaginal birth after cesarean ( P <0.05), and pre-pregnancy hypertension ( P <0.05). Conclusions This study from a single center in Poland showed that BMI, preinduction, epidural anesthesia, and family present at birth significantly increased the frequency of labor stimulation with oxytocin. However, a history of previous pregnancies, previous cesarean sections, and pre-pregnancy hypertension significantly reduced the frequency of augmentation of labor with oxytocin.

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Section: Discussionmentioning

confidence: 99%

Use and Effects of Augmentation of Labor with Oxytocin: A Single-Center, Retrospective, Case-Control Study of 4350 Women in Warsaw, Poland, 2015-2020

Bączek

Rychlewicz²,

Budner

et al. 2022

Med Sci Monit

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“…Such subclassification is important from an epidemiological point of view. Each year more deliveries in the world are induced [17], and local algorithms of proceedings differ both in terms of indications and way of pre-induction. The need of pre-induction of labour (in case of low Bishop score) is an adverse factor a priori in relation to successful vaginal delivery [18].…”

Section: Discussionmentioning

confidence: 99%

Robson classification of caesarean sections in two Polish centres on different levels of reference

Młodawski¹,

Mlodawska²,

Nowak³

et al. 2021

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Introduction: Caesarean section (CS) is one of the most common abdominal surgeries performed in the world. The 10-Group Classification System (TGCS, Robson classification) is a World Health Organization recommended classification assessing indications based on 5 variables (parity, previous caesarean section, labour onset, foetal presentation, gestational age, and number of fetuses). The TGCS provides the opportunity to compare indications between different countries, audit, and evaluate of the quality and impact of the recommendations. Aim of the research: Classification of CS data derived from 2 centres according to the TGCS. Material and methods: We used the above-mentioned tool to classify 2000 Caesarean sections from two centres -II and III degree of reference. Results: In both groups, group 5 (RG5 -Robson group 5) constituted the largest part of all Caesarean sections, at 39.9% and 35.17%, respectively. The sum of groups from 1 to 4 (RG 1-4) had a relative contribution to the total number of Caesarean sections in individual centres of 46.94% and 53.48%, respectively. The percentage of occurrence of particular classes was similar in both centres. Conclusions:The results of our study are an attempt to determine the trend in indications for Caesarean sections according to the TGCS in Poland and to popularize the tool used according to WHO recommendations. All activities aimed at effective reduction of the number of Caesarean sections in Poland should be aimed primarily at reducing the percentage of Caesarean sections in the RG5 group. StreszczenieWprowadzenie: Cięcie cesarskie (CC) to jedna z najczęściej wykonywanych operacji brzusznych na świecie. System Robsona oparty na 10 grupach (TGCS -The 10-Group) jest klasyfikacją CC zalecaną przez Światową Organizację Zdrowia. Pacjentki klasyfikowane są na podstawie 5 zmiennych (rodność, obecność blizny po CC na macicy, rozpoczęcie porodu, położenie i liczba płodów oraz wiek ciążowy). TGCS umożliwia porównanie wskazań między różnymi krajami, audyt ośrodków oraz ocenę wpływu zaleceń. Cel pracy: Klasyfikacja CC według TGCS. Materiał i metody: Przy użyciu TGCS sklasyfikowaliśmy 2000 CC z dwóch ośrodków -II i III stopnia referencyjności. Wyniki: W obu grupach grupa 5 (RG5 -Robson group 5) stanowiła największy odsetek wszystkich CC, odpowiednio 39,9% i 35,17%. Suma grup od 1 do 4 (RG 1-4) miała względny udział w ogólnej liczbie CC w poszczególnych ośrodkach, odpowiednio 46,94% i 53,48%. Odsetek występowania poszczególnych klas był podobny w obu ośrodkach. Wnioski: Wyniki naszego badania są próbą określenia trendu wskazań do CC według TGCS w Polsce oraz popularyzacji tego narzędzia. Wszystkie działania mające na celu efektywne zmniejszanie liczby CC w Polsce powinny być ukierunkowane na zmniejszanie liczby pacjentek klasyfikowanych do grupy 5.

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“…In daily practice, such adverse events generate the need for close monitoring of the foetus and labour progression, and increase the workload for staff. The higher frequency of the above-mentioned events did not translate into the rate of the most important neonatal endpoints like reduced Apgar scores, foetal acidosis, and NICU admission [30,31].…”

Section: Misoprostol or Dinoprostone?mentioning

confidence: 85%

“…Uterine tachysystole was more common in the MVI group (RR = 3.34, 95% CI: 2.2-5.07), as well as uterine tachysystole with foetal heart rate involvement (like late decelerations, bradycardia, or prolonged decelerations) (RR = 3.9, 95% CI: 2.35-6.48) and the need for intrapartum tocolysis use (RR = 2.97, 95% CI: 1.96-4.5) [30]. Also, in a cohort of Polish patients the use of MVI in labour pre-induction was associated with an increased risk of CS (OR = 2.14, 95% CI: 1.42-3.23) and vacuum extraction (OR = 3.29, 95% CI: 1.08-10.00) compared to intracervical Foley catheter [31].…”

Section: Misoprostol or Dinoprostone?mentioning

confidence: 90%

Prostaglandins in the induction of labour – do we have the optimal substance, dose, and route of administration? Literature review

Młodawski¹,

Mlodawska²

2021

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Induction of labour (IOL) is a procedure that reduces mortality and morbidity of the mother and the newborn in particular clinical settings. Currently the number of indications for this procedure is increasing; at the same time, intensive work is underway to optimize IOL in terms of duration, obstetric results, and costs. There are no universal standards regarding the optimal way to pre-induce patients in the case of unfavourable cervix, but prostaglandin analogues play an important role in this process. In this paper we discuss the physiological role of prostaglandins and review the current evidence-based literature on this topic, trying to find optimal substance, dose, and route of administration in pre-induction of labour in terms of effectiveness, obstetrical outcomes, and intrapartum complications. StreszczenieIndukcja porodu (IOL) to procedura zmniejszająca śmiertelność i zachorowalność matki oraz noworodka w wybranych sytuacjach klinicznych. Aktualnie obserwujemy wzrost liczby wskazań do tej procedury, jednocześnie prowadzone są intensywne badania nad optymalizacją IOL pod względem czasu trwania, wyników położniczych i kosztów. Obecnie nie ma uniwersalnych standardów dotyczących optymalnego sposobu przygotowania szyjki u pacjentek w przypadku jej niedojrzałości, ale analogi prostaglandyn odgrywają niezwykle ważną rolę w tym procesie. W niniejszym artykule omawiamy fizjologiczną rolę prostaglandyn i dokonujemy przeglądu aktualnego piśmiennictwa opartego na dowodach naukowych w celu znalezienia optymalnej substancji, dawki i drogi podania w preindukcji porodu pod względem skuteczności, wyników położniczych i powikłań śródporodowych.

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Misoprostol vaginal insert and Foley catheter in labour induction — single center retrospective observational study of obstetrical outcome

Cited by 6 publications

References 11 publications

Use and Effects of Augmentation of Labor with Oxytocin: A Single-Center, Retrospective, Case-Control Study of 4350 Women in Warsaw, Poland, 2015-2020

Use and Effects of Augmentation of Labor with Oxytocin: A Single-Center, Retrospective, Case-Control Study of 4350 Women in Warsaw, Poland, 2015-2020

Robson classification of caesarean sections in two Polish centres on different levels of reference

Prostaglandins in the induction of labour – do we have the optimal substance, dose, and route of administration? Literature review

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