European journal of obstetrics, gynecology, and reproductive biology · 2025
Rupture of membrane at term. Titled oral misoprostol: a most effective labor induction method compared to vaginal prostaglandin: Titled oral Misoprostol in tPROM induction.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Algeri Paola, Rezzan Giorgia, Bosio Mara, Marciello Mauro, Cagninelli Greta, Giannico Serena, Bica Francesca, Bonalumi Silvia Giovanna, Ermito Santina, Liguori Antonella, Rinaldo Denise, Alessandra Piavani, Von Wunster Silvia, D'Oria Patrizia
Аннотация
BACKGROUND: Labor induction in singleton pregnancies with term premature rupture of membranes and a low Bishop score presents clinical challenges and remains a subject of ongoing research and debate.
OBJECTIVE: To evaluate the safety and efficacy of oral titled Misoprostol (PGE1) compared to vaginal Dinoprostone (PGE2).
STUDY DESIGN: A retrospective study was conducted at Bolognini Hospital, ASST Bergamo-EST, including pregnant women with term premature rupture of membrane and unfavorable cervix who required labor induction between January 2022 and December 2023. Maternal, delivery, and neonatal outcomes were compared between patients who received oral PGE1 and those who received vaginal PGE2.
RESULTS: A total of 185 patients met the inclusion criteria (105 in the oral PGE1 group, 80 in the vaginal PGE2 group). Oral misoprostol resulted in a significantly lower need for oxytocin, shorter induction-to-delivery intervals, and reduced analgesia requirements compared to vaginal PGE2. The first stage of labor was also shorter in the oral Misoprostol group. Neonatal outcomes, including birth weight and Apgar scores, were similar between the two groups. Multivariate analysis showed that oral Misoprostol independently reduced the risk of oxytocin use by approximately 60%.
CONCLUSION: Titled oral Misoprostol seemed a safe and effective method for labor induction in women with tPROM and a low Bishop score. It significantly reduced the need for oxytocin augmentation, shortened induction-to-delivery time, and maintained similar maternal, delivery and neonatal outcomes compared to vaginal PGE2. Oral Misoprostol should be considered a viable alternative in this population.
OBJECTIVE: To evaluate the safety and efficacy of oral titled Misoprostol (PGE1) compared to vaginal Dinoprostone (PGE2).
STUDY DESIGN: A retrospective study was conducted at Bolognini Hospital, ASST Bergamo-EST, including pregnant women with term premature rupture of membrane and unfavorable cervix who required labor induction between January 2022 and December 2023. Maternal, delivery, and neonatal outcomes were compared between patients who received oral PGE1 and those who received vaginal PGE2.
RESULTS: A total of 185 patients met the inclusion criteria (105 in the oral PGE1 group, 80 in the vaginal PGE2 group). Oral misoprostol resulted in a significantly lower need for oxytocin, shorter induction-to-delivery intervals, and reduced analgesia requirements compared to vaginal PGE2. The first stage of labor was also shorter in the oral Misoprostol group. Neonatal outcomes, including birth weight and Apgar scores, were similar between the two groups. Multivariate analysis showed that oral Misoprostol independently reduced the risk of oxytocin use by approximately 60%.
CONCLUSION: Titled oral Misoprostol seemed a safe and effective method for labor induction in women with tPROM and a low Bishop score. It significantly reduced the need for oxytocin augmentation, shortened induction-to-delivery time, and maintained similar maternal, delivery and neonatal outcomes compared to vaginal PGE2. Oral Misoprostol should be considered a viable alternative in this population.