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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Created on : 26 Nov 2017
Modified on : 26 Nov 2017

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Bibliographical entry (without author) :

Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol - Journal of Perinatal Medicine - Vol. 42, 5 - p.603-609

Author(s) :

Kreft, M.; Krähenmann, F.; Roos, M.; Kurmanavicius, J.; Zimmermann, R.; Ochsenbein-Kölble, N.

Year of publication :


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Résumé (français)  :

Abstract (English)  :

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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Keywords :

➡ induction of labor ; misoprostol (Cytotec)

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Import 26/11/2017 — 26 Nov 2017

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