Misoprostol vs dinoprostone vaginal insert in labour induction: comparison of obstetrical outcome

Abstract

Induction of labour (IOL) is increasingly used in obstetric practice. For patients with unfavourable cervix, we are constantly looking for an optimal, in terms of effectiveness and safety, ripening of cervix protocol. It was retrospective cohort study. We analyzed obstetrical results in 481 patients undergoing IOL in one center using two different vaginal inserts that release prostaglandins at a constant rate for 24 h—misoprostol vaginal insert (MVI) with 200 µg of misoprostol (n = 367) and dinoprostone vaginal insert (DVI) with 10 mg of dinoprostone (n = 114). Full-term, single pregnancy patients with intact fetal membranes and the cervix evaluated in Bishop score ≤ 6 were included in the analysis. In the group of MVI patients, the labour ended with caesarean section more often (OR 2.71 95% CI 1.63–4.47) and more frequent unreassuring cardiotocographic trace indicating the surgical delivery occurred (OR 2.38 95% CI 1.10–5.17). We did not notice any differences in the percentage of vacuum extraction and patients in whom the use of oxytocin was necessary during labour induction. The clinical status of newborns after birth and the pH of cord blood did not differ between groups.The use of MVI 200 μg in patients with an unriped cervix is associated with a greater chance of completing delivery by caesarean section and increased chance of abnormal intrapartum CTG trace compared to the use of DVI 10 mg. These differences do not affect the clinical and biochemical status of the newborn.

Comparative study of dinoprostone and misoprostol for induction of labor in patients with premature rupture of membranes after 35 weeks

“…In a recent study, Mlodawski et al compared misoprostol vaginal insert versus dinoprostone vaginal insert for the induction of labor with intact membranes. Their results are in accordance with ours and indicate an increased risk of cesarean section with vaginal misoprostol (OR 2.71 95% CI 1.63–4.47) 15 . In recent years, several studies have focused on the induction of labor with misoprostol, but few have studied the specific case of PROM.…”

Results of Induction of Labor with Prostaglandins E1 and E2 (The RIPE Study): A Real-World Data Analysis of Obstetrical Effectiveness and Clinical Outcomes of Pharmacological Induction of Labor with Vaginal Inserts

“…The presented data are consistent with the studies conducted so far on the effectiveness of the use of prostaglandins in labor induction [ 44 , 45 , 46 ].…”

The dynamic inflammatory profile of pregnancy can be monitored using a novel lipid-based mass spectrometry technique

“…Cleavage of PC by phospholipase A 2 (PLA 2 ) produces lysophosphotidylcholine (LPC) with free-fatty acids, such as polyunsaturated fatty acids (PUFAs) which are the precursors for eicosanoids, released as by-products. This generates a variety of downstream cellular effectors, with the lipid mediators produced being involved in both pro-(e.g., prostaglandins [4][5][6] ) and anti-(e.g., resolvins [7][8][9][10] ) inflammatory processes. Inflammation describes the response to a pathogen, tissue damage or injury that presents with the hallmarks of swelling, pain, heat, redness, and loss of function and is driven by various cellular (e.g., macrophages, neutrophils and eosinophils) and soluble mediators (e.g., lipid mediators and cytokines) some of which will be pro-inflammatory and drive the occurrence, maintenance and/or exacerbation of inflammation and others that are anti-inflammatory and serve to dampen this response and support resolution and repair.…”

“…This generates a variety of downstream cellular effectors, with the lipid mediators produced being involved in both pro- ( e.g. , prostaglandins 4–6 ) and anti- ( e.g. , resolvins 7–10 ) inflammatory processes.…”