A comparison of two dosage regimens of oral misoprostol for labor induction at term

被引:20
作者
Shetty, A [1 ]
Martin, R [1 ]
Danielian, P [1 ]
Templeton, A [1 ]
机构
[1] Aberdeen Matern Hosp, Dept Obstet & Gynaecol, Aberdeen AB25 2ZD, Scotland
关键词
oral misoprostol; labor induction; failed induction;
D O I
10.1034/j.1600-0412.2002.810411.x
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Methods. 251 women with indications for labor induction at term were randomised to receive either 50 or 100 mugs of oral misoprostol, repeated every 4 h to a maximum of 5 doses. Parous women in the higher dose group received 50 mugs as their first dose, subsequent doses being 100 Digs. Women who failed to respond to the 5 doses of misoprostol had the option of having vaginal PGE2 gel. The primary outcome measure was the induction to delivery interval in those who delivered vaginally. Patient satisfaction was assessed by postnatal questionnaire. Results. The induction to vaginal delivery interval, although shorter in the 100 Digs group was not statistically significant (26.8 versus 33.7h, mean difference 6.9h, 95% CI 0.4-13). There were, however, more failed inductions with misoprostol in the 50 mugs group (12.7% Vs 4.8%, RR 2.6, 95% Cl 1.07-6.5). There were no differences in the modes of delivery, number of caesarean sections for fetal distress or in the neonatal outcomes in the two groups. Most patients, 83% and 92% in the 50 and 100 mugs, respectively, were satisfied with their inductions, and 64% of patients would prefer to have the inducing agent given orally if they were to have another induction. Conclusion. Oral misoprostol is effective in inducing labor and seems acceptable to patients. Both the 50 and 100 mugs dose regimens have a reasonable safety profile, but in view of the higher incidence of failed inductions with the 50 mugs dosage, the 100 mugs dose regimen may be the preferred dose regimen.
引用
收藏
页码:337 / 342
页数:6
相关论文
共 10 条
[1]   Oral or vaginal misoprostol administration for induction of labor: A randomized, double-blind trial [J].
Adair, CD ;
Weeks, JW ;
Barrilleaux, S ;
Edwards, M ;
Burlison, K ;
Lewis, DF .
OBSTETRICS AND GYNECOLOGY, 1998, 92 (05) :810-813
[2]   A masked randomized comparison of oral and vaginal administration of misoprostol for labor induction [J].
Bennett, KA ;
Butt, K ;
Crane, JMG ;
Hutchens, D ;
Young, DC .
OBSTETRICS AND GYNECOLOGY, 1998, 92 (04) :481-486
[3]  
CALDER AA, 1974, J OBSTET GYN BR COMM, V81, P39
[4]  
FARAH LA, 1999, AM J OBSTET GYNECOL, V180, P1543
[5]   Misoprostol for induction of labour:: a systematic review [J].
Hofmeyr, GJ ;
Gülmezoglu, AM ;
Alfirevic, Z .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1999, 106 (08) :798-803
[6]   Misoprostol is more efficacious for labor induction than prostaglandin E2, but is it associated with more risk? [J].
Kolderup, L ;
McLean, L ;
Grullon, K ;
Safford, K ;
Kilpatrick, SJ .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1999, 180 (06) :1543-1548
[7]   A comparison of oral and vaginal misoprostol tablets in induction of labour at term [J].
Shetty, A ;
Danielian, P ;
Templeton, A .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2001, 108 (03) :238-243
[8]  
VARAKLIS K, 1995, OBSTET GYNECOL, V173, P1137
[9]   Oral administration of misoprostol for labor induction: A randomized controlled trial [J].
Windrim, R ;
Bennett, K ;
Mundle, W ;
Young, DC .
OBSTETRICS AND GYNECOLOGY, 1997, 89 (03) :392-397
[10]   Absorption kinetics of misoprostol with oral or vaginal administration [J].
Zieman, M ;
Fong, SK ;
Benowitz, NL ;
Banskter, D ;
Darney, PD .
OBSTETRICS AND GYNECOLOGY, 1997, 90 (01) :88-92