Comparison of vaginal misoprostol, laminaria, and isosorbide dinitrate on cervical preparation and labor duration of term parturient: a randomized double-blind clinical trial

Souizi, Behnaz; Mortazavi, Forough; Haeri, Sima; Borzoee, Fateme

doi:10.19082/6756

Cited by 12 publications

(13 citation statements)

References 18 publications

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“…Another study also reported that the time interval between labor induction and the labor active phase in the misoprostol group was not significantly different from the EASI group probably due to the fact that the EASI catheter had been using traction [12]. In line with our findings, a study reported that the time interval between labor induction and the labor active phase in the misoprostol group was significantly shorter than that in the laminaria group [9]. However, contrary to our findings, another study showed that this time interval in the misoprostol group did not significantly differ from the EASI group [14].…”

Section: Discussionsupporting

confidence: 89%

“…Our findings also revealed that the induction to delivery time interval in the misoprostol group was significantly shorter than that in the laminaria group. A previous study reported the same findings [9], while another study reported no significant differences between these groups regarding the induction to delivery time intervals [10].…”

Section: Discussionsupporting

confidence: 62%

“…In line with these findings, a study reported a higher prevalence of cesarean sections in the misoprostol group than in the EASI group [13]. Two other studies also reported that cesarean section rates in the misoprostol group were significantly greater than those in the laminaria group, though there were no significant between group differences regarding the indications for cesarean sections [9,10]. Moreover, in line with our findings, a previous study reported no significant differences between the laminaria and the trans-cervical groups regarding the routes of delivery [8].…”

Section: Discussionmentioning

confidence: 75%

“…In the present study, the Bishop score increase in the EASI group was significantly greater than that in the other 2 groups. Contrary to this finding, some studies reported that the Bishop score increase in the misoprostol group was greater than that in either the EASI or laminaria group [9,11,16]. An explanation for this contradiction is the difference among the studies regarding misoprostol dosages.…”

Section: Discussionmentioning

confidence: 79%

“…A study reported that the time interval from labor induction to the labor active phase in the EASI group was shorter than that in the laminaria group, and there were no significant differences in complications between these 2 methods [8]. One study indicated that misoprostol was more effective than laminaria in increasing the Bishop scores and shortening labor durations, though cesarean section rates in the misoprostol group were greater [9]. However, another study found that although this interval was shorter in the laminaria group than in the misoprostol group, the difference was not statistically significant.…”

Section: Introductionmentioning

confidence: 99%

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Comparing the effects of vaginal misoprostol, laminaria, and extra amniotic saline infusion on cervical ripening and induction of labor

et al. 2020

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Objective This study aimed to compare the effects of vaginal misoprostol, laminaria, and extra-amniotic saline infusion (EASI) on cervical ripening. Methods This randomized controlled trial was conducted on 195 women with singleton pregnancies and unripe cervices. Participants were randomly allocated to 3, 65-person groups: a misoprostol, a laminaria, and an EASI group. The interventions in the misoprostol, laminaria, and EASI groups included a single 25-µg vaginal misoprostol suppository, an intracervical laminaria, and a transcervical Foley catheter, respectively. The groups were compared with each other regarding time intervals from labor induction to labor active phase and delivery, cervical dilation, Bishop scores 6 hours after induction, delivery type, length of hospital stay, and complications. Results There were no significant differences among the groups regarding maternal ages, gestational ages, body mass indices, baseline cervical dilations, and Bishop scores (P>0.05). Six hours after induction, the Bishop score and cervical dilation were significantly greater in the EASI group than in the other 2 groups (P<0.001). Moreover, time intervals from labor induction to labor active phase and delivery in the EASI group were significantly short (P<0.001). The rates of cesarean section, fetal distress, placental abruption, and meconium staining in the misoprostol group were significantly high (P<0.05), and the length of hospital stay in the EASI group was significantly short (P<0.001). Conclusion EASI is a safer and more effective method for cervical ripening. Considering its inexpensiveness, easy accessibility, and greater effectiveness, EASI is recommended for cervical ripening.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

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Comparing the effects of vaginal misoprostol, laminaria, and extra amniotic saline infusion on cervical ripening and induction of labor

et al. 2020

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Mechanical methods for induction of labour

Vaan

Eikelder

Jozwiak

et al. 2019

Cochrane Database of Systematic Reviews

101

117

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BackgroundMechanical methods were the first methods developed to ripen the cervix and induce labour. During recent decades they have been substituted by pharmacological methods. Potential advantages of mechanical methods, compared with pharmacological methods may include reduction in side effects that could improve neonatal outcomes. This is an update of a review first published in 2001, last updated in 2012.ObjectivesTo determine the effectiveness and safety of mechanical methods for third trimester (> 24 weeks' gestation) induction of labour in comparison with prostaglandin E2 (PGE2) (vaginal and intracervical), low‐dose misoprostol (oral and vaginal), amniotomy or oxytocin.Search methodsFor this update, we searched Cochrane Pregnancy and Childbirth’s Trials Register, , the WHO International Clinical Trials Registry Platform (), and reference lists of retrieved studies (9 January 2018). We updated the search in March 2019 and added the search results to the awaiting classification section of the review.Selection criteriaClinical trials comparing mechanical methods used for third trimester cervical ripening or labour induction with pharmacological methods.Mechanical methods include: (1) the introduction of a catheter through the cervix into the extra‐amniotic space with balloon insufflation; (2) introduction of laminaria tents, or their synthetic equivalent (Dilapan), into the cervical canal; (3) use of a catheter to inject fluid into the extra‐amniotic space (EASI).This review includes the following comparisons: (1) specific mechanical methods (balloon catheter, laminaria tents or EASI) compared with prostaglandins (different types, different routes) or with oxytocin; (2) single balloon compared to a double balloon; (3) addition of prostaglandins or oxytocin to mechanical methods compared with prostaglandins or oxytocin alone.Data collection and analysisTwo review authors independently assessed trials for inclusion and assessed risk of bias. Two review authors independently extracted data and assessed the quality of the evidence using the GRADE approach.Main resultsThis review update includes a total of 113 trials (22,373 women) contributing data to 21 comparisons. Risk of bias of trials varied. Overall, the evidence was graded from very‐low to moderate quality. All evidence was downgraded for lack of blinding and, for many comparisons, the effect estimates were too imprecise to make a valid judgement.Balloon versus vaginal PGE2: there may be little or no difference in vaginal deliveries not achieved within 24 hours (average risk ratio (RR) 1.01, 95% confidence interval (CI) 0.82 to 1.26; 7 studies; 1685 women; I² = 79%; low‐quality evidence) and there probably is little or no difference in caesarean sections (RR 1.00, 95% CI 0.92 to 1.09; 28 studies; 6619 women; moderate‐quality evidence) between induction of labour with a balloon catheter and vaginal PGE2. A balloon catheter probably reduces the risk of uterine hyperstimulation with fetal heart rate (FHR) changes (RR 0.35, 95% CI 0.18 to 0.67; 6 studies; 1966 ...

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