Sequential use of oral and vaginal misoprostol versus oral or vaginal misoprostol alone for induction of labor and the caesarean delivery risk: a retrospective study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20241441Keywords:
Misoprostol, Induction of labor, Caesarean sections, PPHAbstract
Background: Induction of labor is now a common practice and every institute faces the task of developing a safe and cost-effective protocol. We aimed to study the effects of sequential use of oral and vaginal misoprostol when compared to oral or vaginal misoprostol alone. Our primary objective was to determine the caesarean delivery rates and secondarily the maternal and neonatal complications between the different induction regimes.
Methods: A single-center retrospective observational study was conducted, with patient records divided into three groups based on their methods of induction: those who were administered vaginal misoprostol only, those who had oral misoprostol only, and those who had oral misoprostol followed by vaginal misoprostol. We extracted all the necessary data from the records and analyzed it using SPSS.
Results: 768 records with comparable demographic characteristics were reviewed. The majority of women were induced at 39 completed weeks. There was no significant difference in the proportion of caesarean deliveries when comparing the three groups but the number of caesarean sections was lower among women who had been administered vaginal misoprostol alone. Among the patients included in the study, the women who developed postpartum hemorrhage received a higher mean dose of misoprostol (130±70 mcg) compared to those who did not (104±57 mcg).
Conclusions: Sequentially administering misoprostol may not decrease the caesarean section rate compared to using only one route of administration. However, it is important to monitor the amount of misoprostol given to each patient to prevent the incidence of PPH.
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References
Allen R, O'Brien BM. Uses of misoprostol in obstetrics and gynecology. Rev Obstet Gynecol. 2009;2(3):159-68.
Braund S, Deneux-Tharaux C, Sentilhes L, Seco A, Rozenberg P, Goffinet F. Induction of labor and risk of postpartum hemorrhage in women with vaginal delivery: A propensity score analysis. Int J Gynecol Obstet. 2023.
Lapuente-Ocamica O, Ugarte L, Lopez-Picado A, Sanchez-Refoyo F, Lasa IL, Echevarria O, et al. Efficacy and safety of administering oral misoprostol by titration compared to vaginal misoprostol and dinoprostone for cervical ripening and induction of labour: study protocol for a randomised clinical trial. BMC Preg Childbirth. 2019;19:14.
Kerr RS, Kumar N, Williams MJ, Cuthbert A, Aflaifel N, Haas DM, et al. Low-dose oral misoprostol for induction of labour. Cochrane Database Syst Rev. 2021;6(6):14484.
Rahimi M, Haghighi L, Baradaran HR, Azami M, Larijani SS, Kazemzadeh P, et al. Comparison of the effect of oral and vaginal misoprostol on labor induction: updating a systematic review and meta-analysis of interventional studies. Eur J Med Res. 2023;28(1):51.
Handal-Orefice RC, Friedman AM, Chouinard SM, Eke AC, Feinberg B, Politch J, et al. Oral or Vaginal Misoprostol for Labor Induction and Cesarean Delivery Risk. Obstet Gynecol. 2019;134(1):10-6.
Roy N, Mishra PK, Mishra VK, Chattu VK, Varandani S, Batham SK. Changing scenario of C-section delivery in India: Understanding the maternal health concern and its associated predictors. J Fam Med Prim Care. 2021;10(11):4182-8.
Brun R, Spoerri E, Schäffer L, Zimmermann R, Haslinger C. Induction of labor and postpartum blood loss. BMC Preg Childbirth. 2019;19(1):265.
Redling K, Schaedelin S, Huhn EA, Hoesli I. Efficacy and safety of misoprostol vaginal insert vs. oral misoprostol for induction of labor. J Perinat Med. 2019;47(2):176-82.
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