Use of Prostaglandin E2 for Cervical Ripening in Pregnancies with Oligohydramnios

Stefos, Theodor; Mouzakioti, E.; Sotiriadis, Alexandros; Andronikou, Styliani; Adamidis, Konstantinos; Lolis, D.

doi:10.1159/000010316

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…9 Similarly, Stefos et al in 2000 revealed no differences in mode of delivery, Apgar's scores, or rates of acidosis with PGE 2 . 11 These findings further support the efficacy and safety of PGEs in the induction for patients with oligohydramnios 9,11 and FGR. 13,14 Conversely, contrary to a recent meta-analysis, 13 our study did not demonstrate an increased rate of CD for abnormal fetal heart rate tracing in pregnancies complicated by oligohydramnios with and without FGR.…”

Section: Results In Context Of What Is Knowncontrasting

confidence: 99%

“…Prior research into the optimal method of induction for patients with fetuses affected by oligohydramnios has revealed mixed results. Rates of adverse neonatal outcomes including acidemia, Apgar <7 at 5 minutes, neonatal intensive care unit (NICU) admission and neonatal deaths were not increased with the use of either prostaglandin E1 (misoprostol) or prostaglandin E2 (dinoprostone) in multiple studies [8][9][10][11] . However the effect of prostaglandins on mode of delivery and need for cesarean for non-reassuring fetal heart rate tracings varied between studies: some show no difference in cesarean delivery (CD) rate [9][10][11][12] while others showed an increased rate of CD in patients with oligohydramnios who received prostaglandins (PGE) 8,12 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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Delivery Mode among Patients with Oligohydramnios with or without Fetal Growth Restriction by Induction Method

et al. 2022

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Objective: To evaluate the association of induction method on delivery mode in pregnancies complicated by oligohydramnios with and without fetal growth restriction (FGR). Methods: This was a secondary analysis of a National Institutes of Health funded retrospective cohort study of singleton deliveries at a tertiary-care hospital between 2002 to 2013 with diabetes, mild hypertension, and/or FGR. Chart abstraction was performed by trained research nurses. Patients with a diagnosis of fetal oligohydramnios with and without FGR were identified. Our analytic cohort was further stratified into three groups per initial induction agent: prostaglandins alone, prostaglandin plus mechanical ripening, or oxytocin only. Primary outcome was mode of delivery. Secondary outcomes included indications for cesarean delivery and neonatal morbidity. Results: Out of 4,929 patients in the original database, 546 subjects with fetal oligohydramnios were identified; of these 270 were induced and included for analysis. Outcomes were compared between 171 patients who had fetuses with isolated oligohydramnios and 99 patients who had fetuses with oligohydramnios and FGR. There were no significant differences in demographic characteristics between groups. Patients with fetuses with isolated oligohydramnios had similar rates of spontaneous vaginal delivery (SVD) when prostaglandins were used (n=44/79, 55.7% prostaglandin alone, n=44/76, 57.9% prostaglandin with mechanical ripening) and when they were not used (n=5/13, 38.5% oxytocin alone) (p=0.43). Similarly, the majority of patients in both cohorts underwent SVD regardless of induction method (n=30/44, 68.2% prostaglandin alone, n=30/44, 68.2% prostaglandin with mechanical ripening, and n=6/10, 60% oxytocin alone) (p=0.90). There was no significant difference in composite neonatal morbidity. Conclusion: In patients with fetuses with oligohydramnios with and without FGR, most patients delivered by SVD regardless of induction method. In this population, prostaglandin use was associated with a high chance of SVD in patients with fetuses with suspected placental insufficiency regardless of the presence of absence of FGR.

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Section: Results In Context Of What Is Knowncontrasting

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Delivery Mode among Patients with Oligohydramnios with or without Fetal Growth Restriction by Induction Method

et al. 2022

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“…Although there are studies testing the safety and efficacy of different prostaglandin preparations such as prostaglandin E 2 for labor induction in cases with oligohydramnios [12,13], currently there is no study in the literature focusing on the efficacy and safety of misoprostol for cervical ripening and labor induction in oligohydramniotic patients. Data on the effectiveness of misoprostol are promising [7].…”

Section: Discussionmentioning

confidence: 99%

Misoprostol for Cervical Ripening and Labor Induction in Pregnancies with Oligohydramnios

Dede¹,

Haberal²,

Dede³

et al. 2004

Gynecol Obstet Invest

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The efficacy and safety of misoprostol for cervical ripening and labor induction in patients with oligohydramnios was investigated. 57 pregnancies with oligohydramnios and 58 cases with a normal amniotic fluid volume (controls) were enrolled in this prospective trial. All patients received 50 µg of intravaginal misoprostol every 5 h. Primary outcomes were: cesarean section rate; induction to delivery time; oxytocin augmentation; uterine hyperstimulation; meconium passage; fetal heart rate (FHR) changes; fetal distress requiring delivery, and Apgar scores. There were no differences in the mean time to delivery, cesarean section rate, oxytocin augmentation or Apgar scores. The mean induction to delivery time in oligohydramnios and control groups were, 11 h 43 min and 11 h 18 min, respectively (p > 0.05). FHR changes were observed in 26.3% of oligohydramnios group and 32.7% of control group (p > 0.05). There was no statistically significant difference in the cesarean section rate and the uterine hyperstimulation between the 2 groups. These data suggest that misoprostol can be used as an effective agent for cervical ripening and labor induction in pregnancies with oligohydramnios without increasing the risk for perinatal outcome, compared to those with normal amniotic fluid volumes.

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Prostaglandin E2 induction of labor and cervical ripening for term isolated oligohydramnios in pregnant women with Bishop score ≤ 5

Kansu-Celik¹,

Gun-Eryılmaz²,

Doğan³

et al. 2017

Journal of the Chinese Medical Association

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Use of Prostaglandin E2 for Cervical Ripening in Pregnancies with Oligohydramnios

Cited by 3 publications

References 12 publications

Delivery Mode among Patients with Oligohydramnios with or without Fetal Growth Restriction by Induction Method

Delivery Mode among Patients with Oligohydramnios with or without Fetal Growth Restriction by Induction Method

Misoprostol for Cervical Ripening and Labor Induction in Pregnancies with Oligohydramnios

Prostaglandin E2 induction of labor and cervical ripening for term isolated oligohydramnios in pregnant women with Bishop score ≤ 5

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