@2024 Afarand., IRAN
ISSN: 2252-0805 The Horizon of Medical Sciences 2016;22(2):103-109
ISSN: 2252-0805 The Horizon of Medical Sciences 2016;22(2):103-109
Comparison of Oral and Vaginal Prescription of Misoprostol in Labor Induction of Post-Term Pregnancies
ARTICLE INFO
Article Type
Original ResearchAuthors
Rezaie M. (1)Seyedoshohadaei F. (1)
Mirzamohammadi S. (*)
Gharibi F. (2)
(*) Obstetrics & Gynecology Department, Medicine Faculty, Kurdistan University of Medical Sciences, Sanandaj, Iran
(1) Obstetrics & Gynecology Department, Medicine Faculty, Kurdistan University of Medical Sciences, Sanandaj, Iran
(2) Tohid Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
Correspondence
Address: Keshavarz Street, Mardookh Junction, Be’sat Hospital, Sanandaj, IranPhone: +988733285910
Fax: +988733285911
sumimo54@yahoo.com
Article History
Received: January 16, 2015Accepted: June 2, 2015
ePublished: March 5, 2016
ABSTRACT
Aims
There is a considerable increase in the maternal and infancy mortality and side-effects in accordance with higher pregnancy ages. Due to such a risk, it is nedded to statrt the labor induction from week 40. Misoprostol is one of the medications used in such conitions. The aim of this study was to compare the effects of oral misoprostol and vaginal misoprostol in the labor induction in the prolonged pregnancy.
Materials & Methods In the two-blinded random climical trial, 180 pregnant women with more than 40 weeks gestational age referred to the labor ward of Sanadaj Besat Hospital were studied in 2013-2014. The samples were selected via randomized blocking sampling method. Through sixtuple random blocking method, the subjects were divided into three groups including 50μg oral misoprostol, 100μg oral misoprostol, and 25μg vaginal misoprostol. Having been recorded on a checklist, data was analyzed by SPSS 18 software using one-way ANOVA, Chi-square, and Fisher’s exact tests.
Findings There were significant differences between the mean 1st minute Apgar score and the medication consumption dose in the groups (p=0.0001). There were no differences between the groups in the mean 5th minute Apgar score, induction frequency, induction times, mode of delivery, and its side-effects (p>0.05). Nevertheless, there were significant differences in fetal distress frequency and the infant hospitalization (p<0.05). There were no significant differences in the mean interval between misoprostrol consumption and the delivery time between the groups (p=0.28).
Conclusion Considering the labor induction time and maternal and infancy outcomes, administration of 100μg oral misoprostrol in the prolonged pregnant women is more useful than 50μg oral misoprostrol and 25μg vaginal misoprostrol.
Materials & Methods In the two-blinded random climical trial, 180 pregnant women with more than 40 weeks gestational age referred to the labor ward of Sanadaj Besat Hospital were studied in 2013-2014. The samples were selected via randomized blocking sampling method. Through sixtuple random blocking method, the subjects were divided into three groups including 50μg oral misoprostol, 100μg oral misoprostol, and 25μg vaginal misoprostol. Having been recorded on a checklist, data was analyzed by SPSS 18 software using one-way ANOVA, Chi-square, and Fisher’s exact tests.
Findings There were significant differences between the mean 1st minute Apgar score and the medication consumption dose in the groups (p=0.0001). There were no differences between the groups in the mean 5th minute Apgar score, induction frequency, induction times, mode of delivery, and its side-effects (p>0.05). Nevertheless, there were significant differences in fetal distress frequency and the infant hospitalization (p<0.05). There were no significant differences in the mean interval between misoprostrol consumption and the delivery time between the groups (p=0.28).
Conclusion Considering the labor induction time and maternal and infancy outcomes, administration of 100μg oral misoprostrol in the prolonged pregnant women is more useful than 50μg oral misoprostrol and 25μg vaginal misoprostrol.
CITATION LINKS
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[2]Cunningham F, Leveno K, Bloom S, Hauth CY, Dashe J. William's obstetrics. 24nd edition. New York: McGraw-Hill; 2014.
[3]Wolf SB, Sanchesz-Ramos L, Kaunitz AM. Sublingual misoprostol for labor induction: A randomized clinical trial. Obstet Gynecol. 2005;105(2):365-71.
[4]James DK, Steer PJ, Weiner CP, Gonik B. High risk pregnancy: Management options. 4th edition. Philadelphia: Saunders Co; 2010.
[5]Inal HA, Ozturk Inal ZH, Tonguc E, Var T. Comparison of vaginal misoprostol and dinoprostone for cervical ripening before diagnostic hysteroscopy in nulliparous women. Fertil Steril. 2015;103(5):1326-31.
[6]Hill JB, Thigpen BD, Bofill JA, Magann E, Moore LE, Martin JN. A randomized clinical trial comparing vaginal misoprostol versus cervical Foley plus oral misoprostol for cervical ripening and labor induction. Am J Perinatol. 2009;26(1):33-8.
[7]Tang O, Gemzell-Danielsson K, Ho P. Misoprostol: Pharmacokinetic profiles, effects on the uterus and side-effects. Int J Gynaecol Obstet. 2007;99(Suppl 2):S160-7.
[8]Scheepers HC, van Erp EJ, van den Bergh AS. Use of misoprostol in first and second trimester abortion. Obstet Gynecol Surv. 1999;54(9):592-600.
[9]Zieman M, Fong SK, Benowitz NL, Banskter D, Darney PD. Absorption kinetics of misoprostol with oral or vaginal administration. Obstet Gynecol. 1997;90(1): 88-92.
[10]Bebbington MW, Kent N, Lim K, Gagnon A, Delisle MF, Tessier F, et al. A randomized controlled trial comparing two protocols for the use of misoprostol in midtrimester pregnancy termination. Am J Obstet Gynecol. 2002;187(4):853-7.
[11]Sheela CN, Mhaskar A, George S. Comparison of Vaginal Misoprostol and Oral Misoprostol with intracervical Dinoprostone gel for labour induction at term. J Obstet Gynaecol India. 2007;57(4):327-30.
[12]Jindal P, Avasthi K, Kaur M. A Comparison of Vaginal vs. Oral Misoprostol for Induction of Labor-Double Blind Randomized Trial. J Obstet Gynaecol India. 2011;61(5):538-42.
[13]Wing DA. A benefit-risk assessment of misoprostol for cervical ripening and labour induction. Drug Saf 2002;25(9):665-76.
[14]Jalilian N, Tamizi N, Rezaei M. The effect of vaginal misoprostol and intravenous oxytocin for labor induction. Behbood. 2010;14(3):206-10. [Persian]
[15]Ayaz A, Saeed S, Farooq MU, Ahmad I, Ali Bahoo ML, Saeed M. Labour induction with randomized comparison of oral and intravaginal misoprostol in post date multigravida women. Malays J Med Sci. 2009;16(1):34-8.
[16]Faucett AM, Daniels K, Lee HC, El-Sayed YY, Blumenfeld YJ. Oral misoprostol vs vaginal dinoprostone for labor induction in nulliparous women at term. J Perinatol. 2014;34(2):95-9.
[17]Diro M, Adra A, Gilles JM, Nassar A, Rodriguez A, Salamat SM, et al. A doubleblind randomized trial of two dose regimensof misoprostol for cervical ripening and labor induction. J Matern Fetal Med. 1999;8(3):114-8.
[18]Mohammad-Yari F, Mohit M, Bakhtiyari M, Khezli M, Latifi A. Comparing the effects of vaginal misoprostol and oxytocin in successful induction of labor. J Mazandaran Univ Med Sci. 2012;22(89):77-86. [Persian]
[19]Alfirevic Z, Weeks A. Oral misoprostol for induction of labour. Cochrane Database Syst Rev. 2014;6:CD001338.
[20]Calder AA, Loughney AD, Weir CJ, Barber JW. Induction of labour in nulliparous and multiparous women: A UK, multicentre, openlabel study of intravaginal misoprostol in comparison with dinoprostone. Int J Obstet Gynaecol. 2008;115(10):1279-88.
[21]Tandon L, Gupta H, Singh U, Mehrotra S. O673 comparative study of oral vs vaginal misoprostol for induction of labour. Int J Gynecol Obstet. 2012;119(Suppl 3):S497.
[22]Zhang Y, Wang J, Yu Y, Xie C, Xiao M, Ren L. Misoprostol versus prostaglandin E2 gel for labor induction in premature rupture of membranes after 34 weeks of pregnancy. Int J Gynaecol Obstet. 2015;130(3):214-8.
[23]Voigt F, Goecke TW, Najjari L, Pecks U, Maass N, Rath W. Off-label use of misoprostol for labor induction in Germany: A national survey. Eur J Obstet Gynecol Reprod Biol. 2015;187:85-9.
[24]Rouzi AA, Alsibiani S, Mansouri N, Alsinani N, Darhouse K. Randomized clinical trial between hourly titrated oral misoprostol and vaginal dinoprostone for induction of labor. Am J Obstet Gynecol. 2014;210(1):56.e1-6.
[2]Cunningham F, Leveno K, Bloom S, Hauth CY, Dashe J. William's obstetrics. 24nd edition. New York: McGraw-Hill; 2014.
[3]Wolf SB, Sanchesz-Ramos L, Kaunitz AM. Sublingual misoprostol for labor induction: A randomized clinical trial. Obstet Gynecol. 2005;105(2):365-71.
[4]James DK, Steer PJ, Weiner CP, Gonik B. High risk pregnancy: Management options. 4th edition. Philadelphia: Saunders Co; 2010.
[5]Inal HA, Ozturk Inal ZH, Tonguc E, Var T. Comparison of vaginal misoprostol and dinoprostone for cervical ripening before diagnostic hysteroscopy in nulliparous women. Fertil Steril. 2015;103(5):1326-31.
[6]Hill JB, Thigpen BD, Bofill JA, Magann E, Moore LE, Martin JN. A randomized clinical trial comparing vaginal misoprostol versus cervical Foley plus oral misoprostol for cervical ripening and labor induction. Am J Perinatol. 2009;26(1):33-8.
[7]Tang O, Gemzell-Danielsson K, Ho P. Misoprostol: Pharmacokinetic profiles, effects on the uterus and side-effects. Int J Gynaecol Obstet. 2007;99(Suppl 2):S160-7.
[8]Scheepers HC, van Erp EJ, van den Bergh AS. Use of misoprostol in first and second trimester abortion. Obstet Gynecol Surv. 1999;54(9):592-600.
[9]Zieman M, Fong SK, Benowitz NL, Banskter D, Darney PD. Absorption kinetics of misoprostol with oral or vaginal administration. Obstet Gynecol. 1997;90(1): 88-92.
[10]Bebbington MW, Kent N, Lim K, Gagnon A, Delisle MF, Tessier F, et al. A randomized controlled trial comparing two protocols for the use of misoprostol in midtrimester pregnancy termination. Am J Obstet Gynecol. 2002;187(4):853-7.
[11]Sheela CN, Mhaskar A, George S. Comparison of Vaginal Misoprostol and Oral Misoprostol with intracervical Dinoprostone gel for labour induction at term. J Obstet Gynaecol India. 2007;57(4):327-30.
[12]Jindal P, Avasthi K, Kaur M. A Comparison of Vaginal vs. Oral Misoprostol for Induction of Labor-Double Blind Randomized Trial. J Obstet Gynaecol India. 2011;61(5):538-42.
[13]Wing DA. A benefit-risk assessment of misoprostol for cervical ripening and labour induction. Drug Saf 2002;25(9):665-76.
[14]Jalilian N, Tamizi N, Rezaei M. The effect of vaginal misoprostol and intravenous oxytocin for labor induction. Behbood. 2010;14(3):206-10. [Persian]
[15]Ayaz A, Saeed S, Farooq MU, Ahmad I, Ali Bahoo ML, Saeed M. Labour induction with randomized comparison of oral and intravaginal misoprostol in post date multigravida women. Malays J Med Sci. 2009;16(1):34-8.
[16]Faucett AM, Daniels K, Lee HC, El-Sayed YY, Blumenfeld YJ. Oral misoprostol vs vaginal dinoprostone for labor induction in nulliparous women at term. J Perinatol. 2014;34(2):95-9.
[17]Diro M, Adra A, Gilles JM, Nassar A, Rodriguez A, Salamat SM, et al. A doubleblind randomized trial of two dose regimensof misoprostol for cervical ripening and labor induction. J Matern Fetal Med. 1999;8(3):114-8.
[18]Mohammad-Yari F, Mohit M, Bakhtiyari M, Khezli M, Latifi A. Comparing the effects of vaginal misoprostol and oxytocin in successful induction of labor. J Mazandaran Univ Med Sci. 2012;22(89):77-86. [Persian]
[19]Alfirevic Z, Weeks A. Oral misoprostol for induction of labour. Cochrane Database Syst Rev. 2014;6:CD001338.
[20]Calder AA, Loughney AD, Weir CJ, Barber JW. Induction of labour in nulliparous and multiparous women: A UK, multicentre, openlabel study of intravaginal misoprostol in comparison with dinoprostone. Int J Obstet Gynaecol. 2008;115(10):1279-88.
[21]Tandon L, Gupta H, Singh U, Mehrotra S. O673 comparative study of oral vs vaginal misoprostol for induction of labour. Int J Gynecol Obstet. 2012;119(Suppl 3):S497.
[22]Zhang Y, Wang J, Yu Y, Xie C, Xiao M, Ren L. Misoprostol versus prostaglandin E2 gel for labor induction in premature rupture of membranes after 34 weeks of pregnancy. Int J Gynaecol Obstet. 2015;130(3):214-8.
[23]Voigt F, Goecke TW, Najjari L, Pecks U, Maass N, Rath W. Off-label use of misoprostol for labor induction in Germany: A national survey. Eur J Obstet Gynecol Reprod Biol. 2015;187:85-9.
[24]Rouzi AA, Alsibiani S, Mansouri N, Alsinani N, Darhouse K. Randomized clinical trial between hourly titrated oral misoprostol and vaginal dinoprostone for induction of labor. Am J Obstet Gynecol. 2014;210(1):56.e1-6.