Choose your font:
 Arimo
 Merriweather
 Mukta Malar
 Open Sans Condensed
 Rokkitt
 Source Sans Pro
 Login


 English 
 Français 
 Português 
 Español 

[Valid RSS] RSS
bar

Database - (CIANE)

Description of this bibliographical database (CIANE website)
Currently 3108 records
YouTube channel (tutorial)

https://ciane.net/id=1976

Created on : 15 May 2006
Modified on : 02 Dec 2007

 Modify this record
Do not follow this link unless you know an editor’s password!


Share: Facebook logo   Tweeter logo   Hard

Bibliographical entry (without author) :

Misoprostol for induction of labour: a systematic review. {Afrique du Sud}. Br J Obstet Gynaecol. 1999 Aug;106(8):798-803.

Author(s) :

Hofmeyr GJ, Gulmezoglu AM, Alfirevic Z.

Year of publication :

1999

URL(s) :

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: To determine, from the best available evidence, the effectiveness and safety of misoprostol administered vaginally or orally for third trimester cervical ripening or induction of labour.

METHODS: Clinical trials of misoprostol used for cervical ripening or labour induction in the third trimester were identified from the register of randomised trials maintained by the Cochrane Pregnancy and Childbirth Group. All identified trials were considered for inclusion in the review according to a prespecified protocol. Primary outcomes were chosen to address clinical effectiveness (delivery within 24 hours) and safety (uterine hyperstimulation, caesarean section, serious maternal and neonatal morbidity) and were determined a priori. All meta-analyses were based on the intention-to-treat principle. In the absence of heterogeneity the summary statistics have been expressed as typical relative risk (RR) and 95% confidence interval (CI).

RESULTS: Vaginal misoprostol: one small study showed that the use of misoprostol results in more effective cervical ripening and reduced need for oxytocin when compared with placebo. When compared with oxytocin, vaginal misoprostol was more effective for labour induction. The relative risk of failure to achieve vaginal delivery within 24 hours was 0.48 (95% CI 0.35 to 0.66). However, the relative risks for uterine hyperstimulation with and without fetal heart rate abnormalities were 2.54 (95% CI 1.12 to 5.77) and 2.96 (95% CI 2.11 to 4.14), respectively. In three out of four trials which studied women with intact membranes and unfavourable cervices, failure to achieve vaginal delivery within 24 hours was reduced with misoprostol when compared with other prostaglandins (RR 0.71, 95% CI 0.62 to 0.81). Vaginal misoprostol was associated with increased uterine hyperstimulation both without fetal heart rate changes (RR 1.67, 95% CI 1.30 to 2.14) and with associated fetal heart rate changes (RR 1.45, 95% CI 1.04 to 2.04). There was also an increase in meconium stained amniotic fluid following vaginal misoprostol (RR 1.38, 95% CI 1.06 to 1.79). Oral misoprostol: one small trial suggests that, when compared with placebo, oral misoprostol reduces the need for oxytocin and shortens the time between induction and delivery. Compared with other prostaglandins one small trial showed a reduced need for oxytocin with oral misoprostol. Two trials compared oral with vaginal misoprostol using different doses. No significant differences were evident.

CONCLUSIONS: Overall, misoprostol appears to be more effective than conventional methods of cervical ripening and labour induction. Although no differences in perinatal outcome were shown, the studies were not sufficiently large to exclude the possibility of uncommon serious adverse effects. In particular the increase in uterine hyperstimulation with fetal heart rate changes following misoprostol is a matter for concern. It is possible that, if sufficient numbers are studied, an unacceptably high number of serious adverse events including uterine rupture and asphyxial fetal deaths may occur. The data at present are not robust enough to address the issue of safety. Thus, though misoprostol shows promise as a highly effective, inexpensive and convenient agent for labour induction, it cannot be recommended for routine use at this stage. Lower dose misoprostol regimens should be investigated further.

Sumário (português)  :

Resumen (español)  :

Comments :

Argument (français) :

Argument (English):

Argumento (português):

Argumento (español):

Keywords :

➡ evidence-based medicine/midwifery ; induction of labor ; misoprostol (Cytotec) ; post-term pregnancy

Author of this record :

Cécile Loup — 15 May 2006

Discussion (display only in English)
 
➡ Only identified users



 I have read the guidelines of discussions and I accept all terms
[Hide guidelines]

➡ Discussion guidelines

1) Comments aim at clarifying the content of the publication or suggesting links for a better comprehension of its topic
2) All comments are public and opinions expressed belong to their authors
3) Avoid casual talk and personal stories
4) Any off-topic comment or containing inappropriate statements will be deleted without notice

barre

New expert query --- New simple query

Creating new record --- Importing records

User management --- Dump database --- Contact

bar

This database created by Alliance francophone pour l'accouchement respecté (AFAR) is managed
by Collectif interassociatif autour de la naissance (CIANE, https://ciane.net).
It is fed by the voluntary contributions of persons interested in the sharing of scientific data.
If you agree with this project, you can support us in several ways:
(1) contributing to this database if you have a minimum training in documentation
(2) or financially supporting CIANE (see below)
(3) or joining any society affiliated with CIANE.
Sign in or create an account to follow changes or become an editor.
Contact bibli(arobase)ciane.net for more information.

Valid CSS! Valid HTML!
Donating to CIANE (click “Faire un don”) will help us to maintain and develop sites and public
databases towards the support of parents and caregivers’ informed decisions with respect to childbirth