Overview of the mechanisms of induction of labor

Irani, Roxanna A.; Foster, Sarah E.

doi:10.1053/j.semperi.2015.07.001

Cited by 17 publications

(12 citation statements)

References 42 publications

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“…In six of these patients, the MVI insert was put back vaginally again, and in four of the women labour was established. The average number of doses of oral misoprostol was 5.5 (2)(3)(4)(5)(6)(7)(8), corresponding to a treatment time of 11 hours.…”

Section: Resultsmentioning

confidence: 99%

“…1 International figures for IOL are higher, between 20 and 30%. [2][3][4][5][6] Both maternal as well as fetal complications are related to IOL, such as prolonged labour, postpartum haemorrhage (PPH), and instrumental interventions like vacuum, forceps, or caesarean section (CS) 2,[7][8][9][10] Methods of IOL include amniotomy, mechanical dilatation with a balloon catheter, and pharmacological induction with prostaglandin E1 (misoprostol), prostaglandin E2 (dinoproston), or oxytocin. Misoprostol is a prostaglandin E1 analogue, developed for the treatment and prevention of gastric ulcers.…”

Section: Introductionmentioning

confidence: 99%

“…During the last 5 years, 17% of all singleton pregnancies in Sweden were induced . International figures for IOL are higher, between 20 and 30% . Both maternal as well as fetal complications are related to IOL, such as prolonged labour, postpartum haemorrhage (PPH), and instrumental interventions like vacuum, forceps, or caesarean section (CS)…”

Section: Introductionmentioning

confidence: 99%

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Slow‐release vaginal insert of misoprostol versus orally administrated solution of misoprostol for the induction of labour in primiparous term pregnant women: a randomised controlled trial

Wallstrom

Strandberg

Gemzell‐Danielsson

et al. 2019

BJOG

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Objective To compare the World Health Organization (WHO) recommended orally administrated dosage of misoprostol (25 μg) with a vaginal slow‐release (7 μg/hour) insert of misoprostol regarding time from induction to delivery and safety of the method. Design Open label, Randomised controlled trial (RCT). Setting Delivery ward at a secondary referral hospital in Stockholm, Sweden, from 1 October 2016 to 21 February 2018. Population One hundred and ninety‐six primiparous women with singletons in cephalic presentation at ≥37 weeks of gestation and with a Bishop score of ≤4. Methods Women were randomised to an oral solution of misoprostol (Cytotec® n = 99) or vaginal slow‐release misoprostol (Misodel® [MVI] n = 97). Main outcome measures Primary outcome: time from induction to vaginal delivery. Secondary outcomes: mode of delivery; proportion of vaginal deliveries within 24 hours (VD24); neonates with an Apgar score of <7 at 5 minutes; pH < 7.10; postpartum haemorrhage (PPH) of >1000 ml; hyperstimulation; and women's delivery experience (VAS). Results There was no difference in the time to vaginal delivery (median 21.1 hours in the MVI group and 23.2 hours in the oral group; Kaplan–Mayer log rank P = 0.31). There was no difference regarding the proportion of VD24 (50.5 versus 55.7%, P = 0.16). Hyperstimulation with non‐reassuring cardiotocography (CTG) was more common in the MVI group (14.4 versus 3.0%, P < 0.01). Terbutaline (Bricanyl®) was used more often for hyperstimulation in the MVI group (22.7 versus 4.0%, P < 0.01). There was no difference in the numbers of children admitted to the neonatal intensive care unit (NICU). Conclusions Vaginal delivery after induction of labour (IOL) with slow‐release misoprostol did not result in a shorter time from induction to vaginal delivery, compared with oral misoprostol solution, but was associated with a higher risk for hyperstimulation and fetal distress. There were no differences in mode of delivery or neonatal outcome. Tweetable abstract IOL with MVI was similar to oral solution of misoprostol but hyperstimulation and fetal distress were more common.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Slow‐release vaginal insert of misoprostol versus orally administrated solution of misoprostol for the induction of labour in primiparous term pregnant women: a randomised controlled trial

Wallstrom

Strandberg

Gemzell‐Danielsson

et al. 2019

BJOG

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“…There are two main methods of cervical ripening. One is mechanical, including (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), and the other is pharmacological [1,7,8,14,15,[26][27][28][29][30]. Intracervical Foley catheter is the most common mechanical method that was first described by Embrey and Mollison in 1967, where a Foley is inserted into the cervical canal and dilated just past the internal os with mild traction outward dilating the cervix directly, as well as indirectly stimulating prostaglandin (PG) and oxytocin secretion [31][32][33][34][35][36][37][38].…”

Section: Introductionmentioning

confidence: 99%

Intracervical Foley Catheter Plus Intravaginal Misoprostol vs Intravaginal Misoprostol Alone for Cervical Ripening: A Meta-Analysis

Lee

Huang

Chen

et al. 2020

IJERPH

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Currently, there is no meta-analysis comparing intravaginal misoprostol plus intracervical Foley catheter versus intravaginal misoprostol alone for term pregnancy without identifying risk factors. Therefore, the purpose of this study is to conduct a systematic review and meta-analysis of randomized control trials (RCTs) comparing concurrent intravaginal misoprostol and intracervical Foley catheter versus intravaginal misoprostol alone for cervical ripening. We systematically searched Embase, Pubmed, and Cochrane Collaboration databases for randomized controlled trials (RCTs) comparing intracervical Foley catheter plus intravaginal misoprostol and intravaginal misoprostol alone using the search terms “Foley”, “misoprostol”, “cervical ripening”, and “induction” up to 29 January 2019. Data were extracted and analyzed by two independent reviewers including study characteristics, induction time, cesarean section (C/S), clinical suspicion of chorioamnionitis, uterine tachysystole, meconium stain, and neonatal intensive care unit (NICU) admissions. Data was pooled using random effects modeling and calculated with risk ratio (RR) and 95% confidence interval (CI). Pooled analysis from eight studies, including 1110 women, showed that labor induction using a combination of intracervical Foley catheter and intravaginal misoprostol decreased induction time by 2.71 h (95% CI −4.33 to −1.08, p = 0.001), as well as the risk of uterine tachysystole and meconium staining (RR 0.54, 95% CI 0.30–0.99 and RR 0.48, 95% CI 0.32–0.73, respectively) significantly compared to those using intravaginal misoprostol alone. However, there was no difference in C/S rate (RR 0.93, 95% CI 0.78–1.11) or clinical suspicion of chorioamnionitis rate (RR 1.22, CI 0.58–2.57) between the two groups. Labor induction with a combination of intracervical Foley catheter and intravaginal misoprostol may be a better choice based on advantages in shortening induction time and reducing the risk of uterine tachysystole and meconium staining compared to intravaginal misoprostol alone.

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“…The phases correspond to the physiological changes in the myometrium and cervix during pregnancy as a result of hormonal and mechanical changes (14,(25)(26)(27) (Figure 2). …”

Section: The Process Of Parturitionmentioning

confidence: 99%

Maternal obesity, duration of labor and the role of leptin

Carlhäll¹

2018

Linköping University Medical Dissertations

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Background: The prevalence of obesity substantially increases in pregnant women. Maternal obesity is associated with adverse maternal and neonatal outcomes. The increased risk for cesarean section present in obese women has been related to potential impaired uterine contractility. The mechanism that underlies this theory is not clear. In vitro studies have shown that leptin, produced by adipose tissue and the placenta, exerts an inhibitory effect on myometrial contractility. The aim of this thesis was to evaluate the labor process in relation to maternal body mass index (BMI) and the clinical role of leptin in this process.

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Overview of the mechanisms of induction of labor

Cited by 17 publications

References 42 publications

Slow‐release vaginal insert of misoprostol versus orally administrated solution of misoprostol for the induction of labour in primiparous term pregnant women: a randomised controlled trial

Slow‐release vaginal insert of misoprostol versus orally administrated solution of misoprostol for the induction of labour in primiparous term pregnant women: a randomised controlled trial

Intracervical Foley Catheter Plus Intravaginal Misoprostol vs Intravaginal Misoprostol Alone for Cervical Ripening: A Meta-Analysis

Maternal obesity, duration of labor and the role of leptin

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