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Labor induction in preeclampsia: Is misoprostol more effective than dinoprostone?

Lapaire, Olav ; Zanetti-Dällenbach, Rosanna ; Weber, Patrizia ; Hösli, Irene ; Holzgreve, Wolfgang ; Surbek, Daniel

In: Journal of Perinatal Medicine, 2007, vol. 35, no. 3, p. 195-199

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    Titre
    • Labor induction in preeclampsia: Is misoprostol more effective than dinoprostone?
    Auteur
    • Lapaire, Olav. Department of Obstetrics and Gynecology, University Hospital Basel, Switzerland
    • Zanetti-Dällenbach, Rosanna. Department of Obstetrics and Gynecology, University Hospital Basel, Switzerland
    • Weber, Patrizia. Department of Obstetrics and Gynecology, University Hospital Basel, Switzerland
    • Hösli, Irene. Department of Obstetrics and Gynecology, University Hospital Basel, Switzerland
    • Holzgreve, Wolfgang. Department of Obstetrics and Gynecology, University Hospital Basel, Switzerland
    • Surbek, Daniel. Department of Obstetrics and Gynecology, University Hospital Basel, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Journal of Perinatal Medicine, 2007, vol. 35, no. 3, p. 195-199. Walter de Gruyter
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:292453
    Summary
    Objective: To compare the efficacy of vaginal misoprostol versus dinoprostone for induction of labor (IOL) in patients with preeclampsia according to the WHO criteria. Study design: Ninety-eight patients were retrospectively analyzed. A total of 47 patients received 3mg dinoprostone suppositories every 6h (max. 6mg/24h) whereas 51 patients in the misoprostol group received either 50μg misoprostol vaginally every 12h, or 25μg every 6h (max. 100μg/24h). Primary outcomes were vaginal delivery within 24 and 48h, respectively. Results: The probability of delivering within 48h was more than three-fold higher in the misoprostol than in the dinoprostone group: odds ratio (OR)=3.48; 95% confidence interval (CI) 1.24, 10.30, whereas no significant difference was observed within 24h (P=0.34). No correlation was seen between a ripe cervix prior to IOL and delivery within 24/48h (P=0.33 and P=1.0, respectively). More cesarean sections were performed in the dinoprostone group due to failed IOL (P=0.0009). No significant differences in adverse maternal outcome were observed between both study groups, whereas more neonates (12 vs. 6) of the dinoprostone group were admitted to the NICU (P=0.068). Conclusion: This study suggests that misoprostol may have some advantages compared to dinoprostone, including improved efficacy and lower cost of the drug, even in cases of preeclampsia