Induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets

Abstract Background This study was undertaken with the objective of comparing efficacy and safety for two different regimens using misoprostol for induction of labour. Methods The study was set in two different hospitals in the region of Zeeland, Denmark, and designed as a prospective cohort study. Nulliparous women with unripe cervix, eligible for vaginal delivery and medical induction of labour were included. Exclusion criteria were a previous uterine scar, suspicion of growth restriction of the fetus and prelabour rupture of membranes. One department used 25 mcg oral misoprostol tablets and the other department used 200 mcg slow-release misoprostol vaginal insert, for induction of labour. Primary outcomes were predefined as frequency of cesarean section, tachysystole and delivery within 24 h. Secondary outcomes were: time from induction to delivery, use of additional methods for induction, postpartum hemorrhage, anal sphincter rupture, epidural, pyrexia (rectal temperature < 38.5 °C), prolonged rupture of membranes, and use of tocolysis. Results No significant differences in women achieving vaginal delivery was found. However, a significantly increased risk of tachysystole for the vaginal administration route was observed; 28.4% compared with 2.3%. There were no events of serious neonatal asphyxia. Half of the women induced with vaginal insert delivered within 24 h, compared with 16.8% of the women induced with oral misoprostol. Conclusions Induction with vaginal slow-release misoprostol leads to quicker delivery with an increased risk of tachysystole but with similar perinatal outcomes and rates of cesarean sections. Low-dose oral misoprostol appears to be safe, however it leads to an increased use of secondary methods and a tendency of more intrapartum pyrexia. Trial registration Clinicaltrials.gov ID: NCT02693587 on February 262,016. EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Axelina Eriksson [verfasserIn] Sarah Jeppesen [verfasserIn] Lone Krebs [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	Induced Induction Labour Misoprostol Angusta Misodel

Übergeordnetes Werk:	In: BMC Pregnancy and Childbirth - BMC, 2003, 20(2020), 1, Seite 8
Übergeordnetes Werk:	volume:20 ; year:2020 ; number:1 ; pages:8

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/s12884-020-2770-0

Katalog-ID:	DOAJ055944299

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520			\|a Abstract Background This study was undertaken with the objective of comparing efficacy and safety for two different regimens using misoprostol for induction of labour. Methods The study was set in two different hospitals in the region of Zeeland, Denmark, and designed as a prospective cohort study. Nulliparous women with unripe cervix, eligible for vaginal delivery and medical induction of labour were included. Exclusion criteria were a previous uterine scar, suspicion of growth restriction of the fetus and prelabour rupture of membranes. One department used 25 mcg oral misoprostol tablets and the other department used 200 mcg slow-release misoprostol vaginal insert, for induction of labour. Primary outcomes were predefined as frequency of cesarean section, tachysystole and delivery within 24 h. Secondary outcomes were: time from induction to delivery, use of additional methods for induction, postpartum hemorrhage, anal sphincter rupture, epidural, pyrexia (rectal temperature < 38.5 °C), prolonged rupture of membranes, and use of tocolysis. Results No significant differences in women achieving vaginal delivery was found. However, a significantly increased risk of tachysystole for the vaginal administration route was observed; 28.4% compared with 2.3%. There were no events of serious neonatal asphyxia. Half of the women induced with vaginal insert delivered within 24 h, compared with 16.8% of the women induced with oral misoprostol. Conclusions Induction with vaginal slow-release misoprostol leads to quicker delivery with an increased risk of tachysystole but with similar perinatal outcomes and rates of cesarean sections. Low-dose oral misoprostol appears to be safe, however it leads to an increased use of secondary methods and a tendency of more intrapartum pyrexia. Trial registration Clinicaltrials.gov ID: NCT02693587 on February 262,016. EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered.
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allfields	10.1186/s12884-020-2770-0 doi (DE-627)DOAJ055944299 (DE-599)DOAJ5a404f5991ec45d59d1aed11bf1a4563 DE-627 ger DE-627 rakwb eng RG1-991 Axelina Eriksson verfasserin aut Induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background This study was undertaken with the objective of comparing efficacy and safety for two different regimens using misoprostol for induction of labour. Methods The study was set in two different hospitals in the region of Zeeland, Denmark, and designed as a prospective cohort study. Nulliparous women with unripe cervix, eligible for vaginal delivery and medical induction of labour were included. Exclusion criteria were a previous uterine scar, suspicion of growth restriction of the fetus and prelabour rupture of membranes. One department used 25 mcg oral misoprostol tablets and the other department used 200 mcg slow-release misoprostol vaginal insert, for induction of labour. Primary outcomes were predefined as frequency of cesarean section, tachysystole and delivery within 24 h. Secondary outcomes were: time from induction to delivery, use of additional methods for induction, postpartum hemorrhage, anal sphincter rupture, epidural, pyrexia (rectal temperature < 38.5 °C), prolonged rupture of membranes, and use of tocolysis. Results No significant differences in women achieving vaginal delivery was found. However, a significantly increased risk of tachysystole for the vaginal administration route was observed; 28.4% compared with 2.3%. There were no events of serious neonatal asphyxia. Half of the women induced with vaginal insert delivered within 24 h, compared with 16.8% of the women induced with oral misoprostol. Conclusions Induction with vaginal slow-release misoprostol leads to quicker delivery with an increased risk of tachysystole but with similar perinatal outcomes and rates of cesarean sections. Low-dose oral misoprostol appears to be safe, however it leads to an increased use of secondary methods and a tendency of more intrapartum pyrexia. Trial registration Clinicaltrials.gov ID: NCT02693587 on February 262,016. EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered. Induced Induction Labour Misoprostol Angusta Misodel Gynecology and obstetrics Sarah Jeppesen verfasserin aut Lone Krebs verfasserin aut In BMC Pregnancy and Childbirth BMC, 2003 20(2020), 1, Seite 8 (DE-627)335489087 (DE-600)2059869-5 14712393 nnns volume:20 year:2020 number:1 pages:8 https://doi.org/10.1186/s12884-020-2770-0 kostenfrei https://doaj.org/article/5a404f5991ec45d59d1aed11bf1a4563 kostenfrei https://doi.org/10.1186/s12884-020-2770-0 kostenfrei https://doaj.org/toc/1471-2393 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 20 2020 1 8
spelling	10.1186/s12884-020-2770-0 doi (DE-627)DOAJ055944299 (DE-599)DOAJ5a404f5991ec45d59d1aed11bf1a4563 DE-627 ger DE-627 rakwb eng RG1-991 Axelina Eriksson verfasserin aut Induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background This study was undertaken with the objective of comparing efficacy and safety for two different regimens using misoprostol for induction of labour. Methods The study was set in two different hospitals in the region of Zeeland, Denmark, and designed as a prospective cohort study. Nulliparous women with unripe cervix, eligible for vaginal delivery and medical induction of labour were included. Exclusion criteria were a previous uterine scar, suspicion of growth restriction of the fetus and prelabour rupture of membranes. One department used 25 mcg oral misoprostol tablets and the other department used 200 mcg slow-release misoprostol vaginal insert, for induction of labour. Primary outcomes were predefined as frequency of cesarean section, tachysystole and delivery within 24 h. Secondary outcomes were: time from induction to delivery, use of additional methods for induction, postpartum hemorrhage, anal sphincter rupture, epidural, pyrexia (rectal temperature < 38.5 °C), prolonged rupture of membranes, and use of tocolysis. Results No significant differences in women achieving vaginal delivery was found. However, a significantly increased risk of tachysystole for the vaginal administration route was observed; 28.4% compared with 2.3%. There were no events of serious neonatal asphyxia. Half of the women induced with vaginal insert delivered within 24 h, compared with 16.8% of the women induced with oral misoprostol. Conclusions Induction with vaginal slow-release misoprostol leads to quicker delivery with an increased risk of tachysystole but with similar perinatal outcomes and rates of cesarean sections. Low-dose oral misoprostol appears to be safe, however it leads to an increased use of secondary methods and a tendency of more intrapartum pyrexia. Trial registration Clinicaltrials.gov ID: NCT02693587 on February 262,016. EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered. Induced Induction Labour Misoprostol Angusta Misodel Gynecology and obstetrics Sarah Jeppesen verfasserin aut Lone Krebs verfasserin aut In BMC Pregnancy and Childbirth BMC, 2003 20(2020), 1, Seite 8 (DE-627)335489087 (DE-600)2059869-5 14712393 nnns volume:20 year:2020 number:1 pages:8 https://doi.org/10.1186/s12884-020-2770-0 kostenfrei https://doaj.org/article/5a404f5991ec45d59d1aed11bf1a4563 kostenfrei https://doi.org/10.1186/s12884-020-2770-0 kostenfrei https://doaj.org/toc/1471-2393 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 20 2020 1 8
allfields_unstemmed	10.1186/s12884-020-2770-0 doi (DE-627)DOAJ055944299 (DE-599)DOAJ5a404f5991ec45d59d1aed11bf1a4563 DE-627 ger DE-627 rakwb eng RG1-991 Axelina Eriksson verfasserin aut Induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background This study was undertaken with the objective of comparing efficacy and safety for two different regimens using misoprostol for induction of labour. Methods The study was set in two different hospitals in the region of Zeeland, Denmark, and designed as a prospective cohort study. Nulliparous women with unripe cervix, eligible for vaginal delivery and medical induction of labour were included. Exclusion criteria were a previous uterine scar, suspicion of growth restriction of the fetus and prelabour rupture of membranes. One department used 25 mcg oral misoprostol tablets and the other department used 200 mcg slow-release misoprostol vaginal insert, for induction of labour. Primary outcomes were predefined as frequency of cesarean section, tachysystole and delivery within 24 h. Secondary outcomes were: time from induction to delivery, use of additional methods for induction, postpartum hemorrhage, anal sphincter rupture, epidural, pyrexia (rectal temperature < 38.5 °C), prolonged rupture of membranes, and use of tocolysis. Results No significant differences in women achieving vaginal delivery was found. However, a significantly increased risk of tachysystole for the vaginal administration route was observed; 28.4% compared with 2.3%. There were no events of serious neonatal asphyxia. Half of the women induced with vaginal insert delivered within 24 h, compared with 16.8% of the women induced with oral misoprostol. Conclusions Induction with vaginal slow-release misoprostol leads to quicker delivery with an increased risk of tachysystole but with similar perinatal outcomes and rates of cesarean sections. Low-dose oral misoprostol appears to be safe, however it leads to an increased use of secondary methods and a tendency of more intrapartum pyrexia. Trial registration Clinicaltrials.gov ID: NCT02693587 on February 262,016. EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered. Induced Induction Labour Misoprostol Angusta Misodel Gynecology and obstetrics Sarah Jeppesen verfasserin aut Lone Krebs verfasserin aut In BMC Pregnancy and Childbirth BMC, 2003 20(2020), 1, Seite 8 (DE-627)335489087 (DE-600)2059869-5 14712393 nnns volume:20 year:2020 number:1 pages:8 https://doi.org/10.1186/s12884-020-2770-0 kostenfrei https://doaj.org/article/5a404f5991ec45d59d1aed11bf1a4563 kostenfrei https://doi.org/10.1186/s12884-020-2770-0 kostenfrei https://doaj.org/toc/1471-2393 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 20 2020 1 8
allfieldsGer	10.1186/s12884-020-2770-0 doi (DE-627)DOAJ055944299 (DE-599)DOAJ5a404f5991ec45d59d1aed11bf1a4563 DE-627 ger DE-627 rakwb eng RG1-991 Axelina Eriksson verfasserin aut Induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background This study was undertaken with the objective of comparing efficacy and safety for two different regimens using misoprostol for induction of labour. Methods The study was set in two different hospitals in the region of Zeeland, Denmark, and designed as a prospective cohort study. Nulliparous women with unripe cervix, eligible for vaginal delivery and medical induction of labour were included. Exclusion criteria were a previous uterine scar, suspicion of growth restriction of the fetus and prelabour rupture of membranes. One department used 25 mcg oral misoprostol tablets and the other department used 200 mcg slow-release misoprostol vaginal insert, for induction of labour. Primary outcomes were predefined as frequency of cesarean section, tachysystole and delivery within 24 h. Secondary outcomes were: time from induction to delivery, use of additional methods for induction, postpartum hemorrhage, anal sphincter rupture, epidural, pyrexia (rectal temperature < 38.5 °C), prolonged rupture of membranes, and use of tocolysis. Results No significant differences in women achieving vaginal delivery was found. However, a significantly increased risk of tachysystole for the vaginal administration route was observed; 28.4% compared with 2.3%. There were no events of serious neonatal asphyxia. Half of the women induced with vaginal insert delivered within 24 h, compared with 16.8% of the women induced with oral misoprostol. Conclusions Induction with vaginal slow-release misoprostol leads to quicker delivery with an increased risk of tachysystole but with similar perinatal outcomes and rates of cesarean sections. Low-dose oral misoprostol appears to be safe, however it leads to an increased use of secondary methods and a tendency of more intrapartum pyrexia. Trial registration Clinicaltrials.gov ID: NCT02693587 on February 262,016. EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered. Induced Induction Labour Misoprostol Angusta Misodel Gynecology and obstetrics Sarah Jeppesen verfasserin aut Lone Krebs verfasserin aut In BMC Pregnancy and Childbirth BMC, 2003 20(2020), 1, Seite 8 (DE-627)335489087 (DE-600)2059869-5 14712393 nnns volume:20 year:2020 number:1 pages:8 https://doi.org/10.1186/s12884-020-2770-0 kostenfrei https://doaj.org/article/5a404f5991ec45d59d1aed11bf1a4563 kostenfrei https://doi.org/10.1186/s12884-020-2770-0 kostenfrei https://doaj.org/toc/1471-2393 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 20 2020 1 8
allfieldsSound	10.1186/s12884-020-2770-0 doi (DE-627)DOAJ055944299 (DE-599)DOAJ5a404f5991ec45d59d1aed11bf1a4563 DE-627 ger DE-627 rakwb eng RG1-991 Axelina Eriksson verfasserin aut Induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background This study was undertaken with the objective of comparing efficacy and safety for two different regimens using misoprostol for induction of labour. Methods The study was set in two different hospitals in the region of Zeeland, Denmark, and designed as a prospective cohort study. Nulliparous women with unripe cervix, eligible for vaginal delivery and medical induction of labour were included. Exclusion criteria were a previous uterine scar, suspicion of growth restriction of the fetus and prelabour rupture of membranes. One department used 25 mcg oral misoprostol tablets and the other department used 200 mcg slow-release misoprostol vaginal insert, for induction of labour. Primary outcomes were predefined as frequency of cesarean section, tachysystole and delivery within 24 h. Secondary outcomes were: time from induction to delivery, use of additional methods for induction, postpartum hemorrhage, anal sphincter rupture, epidural, pyrexia (rectal temperature < 38.5 °C), prolonged rupture of membranes, and use of tocolysis. Results No significant differences in women achieving vaginal delivery was found. However, a significantly increased risk of tachysystole for the vaginal administration route was observed; 28.4% compared with 2.3%. There were no events of serious neonatal asphyxia. Half of the women induced with vaginal insert delivered within 24 h, compared with 16.8% of the women induced with oral misoprostol. Conclusions Induction with vaginal slow-release misoprostol leads to quicker delivery with an increased risk of tachysystole but with similar perinatal outcomes and rates of cesarean sections. Low-dose oral misoprostol appears to be safe, however it leads to an increased use of secondary methods and a tendency of more intrapartum pyrexia. Trial registration Clinicaltrials.gov ID: NCT02693587 on February 262,016. EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered. Induced Induction Labour Misoprostol Angusta Misodel Gynecology and obstetrics Sarah Jeppesen verfasserin aut Lone Krebs verfasserin aut In BMC Pregnancy and Childbirth BMC, 2003 20(2020), 1, Seite 8 (DE-627)335489087 (DE-600)2059869-5 14712393 nnns volume:20 year:2020 number:1 pages:8 https://doi.org/10.1186/s12884-020-2770-0 kostenfrei https://doaj.org/article/5a404f5991ec45d59d1aed11bf1a4563 kostenfrei https://doi.org/10.1186/s12884-020-2770-0 kostenfrei https://doaj.org/toc/1471-2393 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 20 2020 1 8
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title_full	Induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets
author_sort	Axelina Eriksson
journal	BMC Pregnancy and Childbirth
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author_browse	Axelina Eriksson Sarah Jeppesen Lone Krebs
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title_sort	induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets
callnumber	RG1-991
title_auth	Induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets
abstract	Abstract Background This study was undertaken with the objective of comparing efficacy and safety for two different regimens using misoprostol for induction of labour. Methods The study was set in two different hospitals in the region of Zeeland, Denmark, and designed as a prospective cohort study. Nulliparous women with unripe cervix, eligible for vaginal delivery and medical induction of labour were included. Exclusion criteria were a previous uterine scar, suspicion of growth restriction of the fetus and prelabour rupture of membranes. One department used 25 mcg oral misoprostol tablets and the other department used 200 mcg slow-release misoprostol vaginal insert, for induction of labour. Primary outcomes were predefined as frequency of cesarean section, tachysystole and delivery within 24 h. Secondary outcomes were: time from induction to delivery, use of additional methods for induction, postpartum hemorrhage, anal sphincter rupture, epidural, pyrexia (rectal temperature < 38.5 °C), prolonged rupture of membranes, and use of tocolysis. Results No significant differences in women achieving vaginal delivery was found. However, a significantly increased risk of tachysystole for the vaginal administration route was observed; 28.4% compared with 2.3%. There were no events of serious neonatal asphyxia. Half of the women induced with vaginal insert delivered within 24 h, compared with 16.8% of the women induced with oral misoprostol. Conclusions Induction with vaginal slow-release misoprostol leads to quicker delivery with an increased risk of tachysystole but with similar perinatal outcomes and rates of cesarean sections. Low-dose oral misoprostol appears to be safe, however it leads to an increased use of secondary methods and a tendency of more intrapartum pyrexia. Trial registration Clinicaltrials.gov ID: NCT02693587 on February 262,016. EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered.
abstractGer	Abstract Background This study was undertaken with the objective of comparing efficacy and safety for two different regimens using misoprostol for induction of labour. Methods The study was set in two different hospitals in the region of Zeeland, Denmark, and designed as a prospective cohort study. Nulliparous women with unripe cervix, eligible for vaginal delivery and medical induction of labour were included. Exclusion criteria were a previous uterine scar, suspicion of growth restriction of the fetus and prelabour rupture of membranes. One department used 25 mcg oral misoprostol tablets and the other department used 200 mcg slow-release misoprostol vaginal insert, for induction of labour. Primary outcomes were predefined as frequency of cesarean section, tachysystole and delivery within 24 h. Secondary outcomes were: time from induction to delivery, use of additional methods for induction, postpartum hemorrhage, anal sphincter rupture, epidural, pyrexia (rectal temperature < 38.5 °C), prolonged rupture of membranes, and use of tocolysis. Results No significant differences in women achieving vaginal delivery was found. However, a significantly increased risk of tachysystole for the vaginal administration route was observed; 28.4% compared with 2.3%. There were no events of serious neonatal asphyxia. Half of the women induced with vaginal insert delivered within 24 h, compared with 16.8% of the women induced with oral misoprostol. Conclusions Induction with vaginal slow-release misoprostol leads to quicker delivery with an increased risk of tachysystole but with similar perinatal outcomes and rates of cesarean sections. Low-dose oral misoprostol appears to be safe, however it leads to an increased use of secondary methods and a tendency of more intrapartum pyrexia. Trial registration Clinicaltrials.gov ID: NCT02693587 on February 262,016. EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered.
abstract_unstemmed	Abstract Background This study was undertaken with the objective of comparing efficacy and safety for two different regimens using misoprostol for induction of labour. Methods The study was set in two different hospitals in the region of Zeeland, Denmark, and designed as a prospective cohort study. Nulliparous women with unripe cervix, eligible for vaginal delivery and medical induction of labour were included. Exclusion criteria were a previous uterine scar, suspicion of growth restriction of the fetus and prelabour rupture of membranes. One department used 25 mcg oral misoprostol tablets and the other department used 200 mcg slow-release misoprostol vaginal insert, for induction of labour. Primary outcomes were predefined as frequency of cesarean section, tachysystole and delivery within 24 h. Secondary outcomes were: time from induction to delivery, use of additional methods for induction, postpartum hemorrhage, anal sphincter rupture, epidural, pyrexia (rectal temperature < 38.5 °C), prolonged rupture of membranes, and use of tocolysis. Results No significant differences in women achieving vaginal delivery was found. However, a significantly increased risk of tachysystole for the vaginal administration route was observed; 28.4% compared with 2.3%. There were no events of serious neonatal asphyxia. Half of the women induced with vaginal insert delivered within 24 h, compared with 16.8% of the women induced with oral misoprostol. Conclusions Induction with vaginal slow-release misoprostol leads to quicker delivery with an increased risk of tachysystole but with similar perinatal outcomes and rates of cesarean sections. Low-dose oral misoprostol appears to be safe, however it leads to an increased use of secondary methods and a tendency of more intrapartum pyrexia. Trial registration Clinicaltrials.gov ID: NCT02693587 on February 262,016. EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered.
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title_short	Induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets
url	https://doi.org/10.1186/s12884-020-2770-0 https://doaj.org/article/5a404f5991ec45d59d1aed11bf1a4563 https://doaj.org/toc/1471-2393
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