Uterine rupture during induction of labor at term with intravaginal misoprostol

Bennett, Barbara B.

doi:10.1016/s0029-7844(97)00036-7

Cited by 74 publications

(29 citation statements)

References 4 publications

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“…It can also occur in an unscarred uterus after a single dose of Table 2 Outcome after induction of labour with either 25 or 50 μg of misoprostol for primi-(1P) and multiparous ( > 1P) women. either 50 μg or even 25 μg, but few cases have been reported [4,17,26]. None occurred in our study.…”

Section: Discussioncontrasting

confidence: 49%

Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol

Kreft

Krähenmann

Roos

et al. 2014

Journal of Perinatal Medicine

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Aim: To compare the efficacy and safety of two misoprostol dosing regimens for induction of labour in primiparous (1P) and multiparous ( > 1P) women. Methods: Retrospective study of induction of labour using vaginal misoprostol 25 μg vs. 50 μg every 6 h in 942 women at a tertiary centre. The main outcome variables are induction-to-delivery interval, latency period duration, vaginal delivery within 24 h, and maternal and foetal safety outcome. Results: With the 50 μg regimen, induction-to-delivery intervals were significantly shorter: 18.4 h vs. 24.6 h (1P) and 14 h vs. 17.9 h ( > 1P), as was latency period duration (by 5.4 and 4 h, respectively). Vaginal delivery within 24 h was significantly more frequent, as were non-reassuring foetal heart rate (1P: 20% vs. 14%) and tachysystole (1P: 31% vs. 11%; > 1P: 21% vs. 7%). No uterine rupture was reported. Neonatal outcomes were similar except for significantly more frequent infant referral to neonatal intensive care in the > 1P group receiving the 50 μg regimen (11% vs. 4%). Conclusion: Vaginal misoprostol 25 μg seems to maintain efficacy with more acceptable maternal and neonatal safety. As induction of labour is an off-label use for misoprostol, safety should be prioritised with the lower dosage regimen despite the longer induction-to-delivery interval.

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Section: Discussioncontrasting

confidence: 49%

Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol

Kreft

Krähenmann

Roos

et al. 2014

Journal of Perinatal Medicine

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“…There are few reports about uterine ruptures in women who had undergone prior cesarean delivery and who were given misoprostol for preinduction of cervical ripening [11][12][13]. There is also a report on a uterine rupture in a multiparous women with no history of cesarean delivery [14]. The cause of uterine ruptures in our case was not clearly attributable to the use of misoprostol.…”

Section: Discussionmentioning

confidence: 54%

Comparison of 25 and 50 μg Vaginally Administered Misoprostol for Preinduction of Cervical Ripening and Labor Induction

Has¹,

Batukan²,

Ermiş³

et al. 2002

Gynecol Obstet Invest

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Our purpose was to compare the efficacy of 25 µg and 50 µg intravaginally administered misoprostol tablets for cervical ripening and labor induction. Either 25-µg (n: 58) or 50-µg (n: 56) misoprostol tablets were randomly administered intravaginally to 114 subjects with an unripe cervix for labor induction. The physician was blinded to the medication. Intravaginal misoprostol was given every 4 h until the onset of labor. The mean Bishop score before misoprostol administration was 2.1 ± 1.6 in the 25-µg group and 2.0 ± 1.4 in the 50-µg group (p > 0.05). With the 25-µg dose the time until delivery was significantly longer (991.2 ± 514.4 min vs. 703.12 ± 432.6 min in the 50-µg group). The use of oxytocin augmentation was significantly higher in the 25-µg group (63.8%) than the 50-µg group (32.1%; p < 0.05). The proportions of patients with tachysystoles and hypersystoles were not significantly different between the two groups (19 and 6.9%, respectively, in the 25-µg group and 25 and 17.8%, respectively, in 50-µg group; p > 0.05). Overall, in the 25-µg group more women achieved vaginal delivery (79.3 vs. 60.7%; p < 0.05). The rate of cesarean sections due to nonreassuring fetal status was higher in the 50-µg misoprostol group (28.6 vs. 10.3%; p < 0.05). The number of neonates with a low 1-min Apgar score (<7) was significantly higher in the 50-µg misoprostol group (26.8 vs. 8.6%; p < 0.05), but 5-min Apgar scores and umbilical artery blood gas values at the time of delivery were not significantly different between the groups (p > 0.05). One patient in the 25-µg group suffered a ruptured uterus. Intravaginal administration of 25 µg of misoprostol is a clinically effective labor induction regimen and has the least adverse effects and complications.

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“…[29][30][31][32] The four women who underwent elective induction followed by a hysterectomy were all induced with oxytocin. This reinforces some authors' views that uterotonics have to be used with caution.…”

Section: Gláucia Virgínia Guerra Et Al Elective Induction Of Labour mentioning

confidence: 99%

Elective induction versus spontaneous labour in Latin America

Guerra

Cecatti

Souza

et al. 2011

Bull World Health Org

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Uterine rupture during induction of labor at term with intravaginal misoprostol

Abstract: Misoprostol can cause excessive uterine activity and uterine rupture.

Cited by 74 publications

References 4 publications

Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol

Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol

Comparison of 25 and 50 μg Vaginally Administered Misoprostol for Preinduction of Cervical Ripening and Labor Induction

Elective induction versus spontaneous labour in Latin America

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