Maternal and perinatal outcomes in women with and without hypertensive syndromes submitted to induction of labor with misoprostol

Marques, Romero; Souza, Alex Sandro Rolland; Feitosa, Francisco Edson de Lucena; Costa, André dos Santos; Amorim, Melânia Maria Ramos

doi:10.1080/10641955.2016.1197935

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…In addition, our previous study of the use of Propess in healthy pregnancies showed a vaginal delivery rate of 76.09%, which was also consistent with our present study. Thus, these results suggested that outcomes of labor induction using dinoprostone in gestational hypertension women were not different from nongestational hypertension women, which has been confirmed by the previous studies . In a post‐hoc analysis of data from three randomized controlled trials, Sheibani et al .…”

Section: Discussionsupporting

confidence: 76%

Use of labor induction with dinoprostone vaginal suppositories in pregnant women with gestational hypertension

Zhou

et al. 2019

J of Obstet and Gynaecol

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Aim: Gestational hypertension is a common disorder of pregnancy. This study aims to evaluate the effect of labor induction with dinoprostone vaginal suppositories (Propess) on pregnancy outcomes in pregnant women with gestational hypertension. Methods: The retrospective study included 375 patients with gestational hypertension. All patients were included into three groups according to the characteristics at admission. Women who had initiated labor spontaneously at admission were enrolled in Spontaneous labor group. According to Bishop score, other patients underwent labor induction with Propess or oxytocin were enrolled in Propess group or Oxytocin group. Demographic information and perinatal outcome data were collected. Results: The vaginal delivery rate of the women with gestational hypertension was respectively 93.5% (Spontaneous labor group), 77.0% (Propess group), and 52.5% (Oxytocin group) in three groups with significant difference (P < 0.001). The duration of labor was 8.29 AE 3.70 h (Spontaneous labor group), 8.45 AE 5.21 h (Propess group) and 12.37 AE 11.47 h (Oxytocin group) in three groups, respectively. No differences were found in the intrapartum fever (P = 0.588), intrapartum hemorrhage (P = 0.953), intrapartum maximum blood pressure (P = 0.301 and P = 0.535) and post-partum hemorrhage (P = 0.075) among three groups. Neonatal outcomes were similar among three groups (Neonatal hospitalization rate, P = 0.437; 1-min Apgar score, P = 0.304; 5-min Apgar score, P = 0.340; Birth weight, P = 0.089). No poor maternal and neonatal outcomes occurred. Conclusion: Pregnant women with gestational hypertension could have favorable pregnancy outcomes. Using Propess as a mode of labor induction in gestational hypertension is safe and effective, without increasing intrapartum blood pressure and inducing poor pregnancy outcomes.*P < 0.05 comparison between Spontaneous labor group and Oxytocin group.; **P < 0.05 comparison between Spontaneous labor group and Propess group.; ***P < 0.05 comparison between Oxytocin group and Propess group.; P value, comparison between three group by One-way analysis of variance. and DBP, diastolic blood pressure; SBP, systolic blood pressure.

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Section: Discussionsupporting

confidence: 76%

Use of labor induction with dinoprostone vaginal suppositories in pregnant women with gestational hypertension

Zhou

et al. 2019

J of Obstet and Gynaecol

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“…No differences were found in perinatal outcomes when misoprostol was used in the groups with and without hypertensive diseases [26] as well as the dinoprostone insert did not adversely affect the perinatal outcomes compared to the group of women with spontaneous or oxytocinstimulated delivery in the group of women with hypertension [27]. In our study, only babies in the subgroup of mothers over 35 years old with any concomitant disease had statistically significant lower average Apgar scores comparing with younger mothers with comorbidities.…”

Section: Discussioncontrasting

confidence: 52%

Pregnancy-related comorbidities and labor induction — the effectiveness and safety of dinoprostone compared to misoprostol

et al. 2021

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Objectives:The aim of the study was to evaluate whether the presence of the disease in pregnancy influences the effectiveness and safety of delivery preinduction with prostaglandins: misoprostol vaginal insert and dinoprostone vaginal gel. Material and methods:This is a retrospective cohort study conducted of 560 pregnant women.The concomitant diseases mainly recorded were diabetes mellitus, hypertensive diseases, intrahepatic cholestasis of pregnancy, asthma, thrombocytopenia, and hypothyroidism. The 2 primary study outcome was a successful vaginal delivery. The study above others evaluates the time from treatment implementation to the beginning of a labor and to a final delivery, the rate of Cesarean sections, and the presence of delivery complications.Results: Among women with a concomitant disease, Caesarean section was observed more frequently in the misoprostol group. In the dinoprostone group, mothers with the concomitant disease as compared to healthy mothers required more time to the delivery and to achieve the beginning of labor. There were no differences in postpartum complications regardless of the prostaglandins, comorbidities or mothers' age. Neonates of mothers ≥ 35 years old with concomitant disease had lower average Apgar scores. Conclusions:Our study showed that comorbidities seem to increase the caesarean section risk in the misoprostol preinduction group but in the dinoprostone group they prolong the time needed to achieve an active labour phase and a delivery.

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“…Thereafter, de Paiva Marques et al (26) documented that maternal and perinatal outcomes were similar in hypertensive and normotensive women submitted to misoprostol IOL. Also, Burgos et al (27) reported that in comparison to spontaneous onset of labor, IOL using either misoprostol or oxytocin in breech presentation at term is a reasonable and effective option and was not associated with increased perinatal morbidity or CS rates.…”

Section: Discussion:-mentioning

confidence: 99%

Misoprostol Induction of Labor in Multipara Pregnant Women: A Mini-Survey for Predictors of Outcome.

MD¹,

MD²

2018

IJAR

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Objectives:To evaluate dose-related outcome of induction of labor (IOL) using misoprostol vaginal inserts (MVI) in multipara pregnant women so as to determine the appropriate dose for getting trial success defined as having vaginal delivery (VD) within 24-hr induction-todelivery (ITD) interval. Patients & Methods: 644 pregnant women underwent clinical evaluation and vaginal examination to determine Bishop score using the Simplified Bishop Score (SBS). All women received 25 µg MVI only once and were monitored for labor progress as judged by SBS and uterine contractions with fetal heart monitoring. In absence of fetal distress manifestations and membranes were still intact, but uterine contractions occurred <3 times/10 minutes, another MVI was used for a maximum of 6 doses. Uterine contraction augmentation was provided as amniotomy or/and oxytocin infusion started 4-hrs after the last MVI was placed. Study outcomes included trail success rate, number of MVI used, frequency and mode of augmentation and delivery assistance. Results: 530 women (82.3%) had VD; 159 women without augmentation, 182 women had amniotomy, 105 women received oxytocin drip and 84 women required both. Only 168 women (26.1%) had instrumentally-assisted VD. Mean ITD interval was 10.9±6.3 hr; 492 women had ITD interval <24 hr for a trial success rate of 76.4%. Cesarean section was indicted in 114 women (17.7%). Only 29 women received four, 71 three, 93 two, while 451 women received one MVI, VD rate was significantly (p<0.00001) lower among women received higher number of MVI. Statistical analyses defined high MVI dose and BMI as negative, while high parity is a positive significant predictor for trial success. High MVI dose and BMI are positive, while high SBS and high parity are negative significant predictors for long ITD interval. Kaplan-Meier regression analysis defined the appropriate MVI for IOL trial success at a mean dose of 1.5±0.039 (95% CI: 1.4-1.55). Conclusion: MVI is a satisfactory modality for IOL trial in multipara pregnant women with VD rate of 82.3% and ITD interval of <24-hr in 76.4%. Lower BMI and higher number of previous VD indicate higher possibility of trial success. SBS is appropriate for women selection for trial and follow-up and can predict outcome if combined with BMI, parity and number of MVI used.

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Maternal and perinatal outcomes in women with and without hypertensive syndromes submitted to induction of labor with misoprostol

Abstract: Maternal and perinatal outcomes were similar in hypertensive and normotensive women submitted to labor induction with misoprostol.

Cited by 5 publications

References 25 publications

Use of labor induction with dinoprostone vaginal suppositories in pregnant women with gestational hypertension

Use of labor induction with dinoprostone vaginal suppositories in pregnant women with gestational hypertension

Pregnancy-related comorbidities and labor induction — the effectiveness and safety of dinoprostone compared to misoprostol

Misoprostol Induction of Labor in Multipara Pregnant Women: A Mini-Survey for Predictors of Outcome.

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