Induction of Labor in Women with Oligohydramnios: Misoprostol Compared with Prostaglandin E2.

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Citation: American Journal of Perinatology. 34(2):204-210, 2017 JanPMID: 27398704Institution: MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Dinoprostone/tu [Therapeutic Use] | *Labor, Induced/mt [Methods] | *Misoprostol/tu [Therapeutic Use] | *Oligohydramnios/th [Therapy] | *Oxytocics | Adult | Blood Transfusion | Cesarean Section | Chorioamnionitis/et [Etiology] | Female | Humans | Infant, Newborn | Intensive Care Units, Neonatal | Length of Stay | Patient Admission | Postpartum Hemorrhage/et [Etiology] | Pregnancy | Respiration, Artificial | Sepsis/et [Etiology] | Young AdultYear: 2017ISSN:
  • 0735-1631
Name of journal: American journal of perinatologyAbstract: <b>Objective</b> To compare perinatal outcomes in women with oligohydramnios and an unfavorable cervix undergoing labor induction with misoprostol to prostaglandin E2. <b>Study Design</b> We conducted a secondary analysis of women with oligohydramnios undergoing labor induction in the Consortium on Safe Labor study (2002-2008). Oligohydramnios was recorded in the medical chart. We evaluated perinatal outcomes. We limited the analysis to women with an unfavorable cervix defined by simplified Bishop score < 4. Misoprostol was compared with prostaglandin E2. Women could have received oxytocin, underwent mechanical dilation, or had artificial rupture of membranes, but women who underwent induction with both misoprostol and prostaglandin E2 were excluded. We calculated adjusted odds ratios with 95% confidence intervals, controlling for maternal age, maternal body mass index (kg/m<sup>2</sup>), parity, and mechanical dilation. <b>Results</b> Among women with oligohydramnios and an unfavorable cervix who underwent induction of labor, 141 (39.4%) received misoprostol and 217 (60.6%) received prostaglandin E2. There were no significant differences in cesarean delivery, chorioamnionitis, postpartum hemorrhage, transfusion, neonatal intensive care unit (NICU) admission, NICU stay>72 hours, mechanical ventilation, and neonatal sepsis. <b>Conclusion</b> In women with oligohydramnios and an unfavorable cervix, induction of labor with misoprostol was comparable to prostaglandin E2.Copyright Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.All authors: Grantz KL, Huang CC, Kawakita T, Kominiarek MA, Landy HJFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-06
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Journal Article MedStar Authors Catalog Article 27398704 Available 27398704

<b>Objective</b> To compare perinatal outcomes in women with oligohydramnios and an unfavorable cervix undergoing labor induction with misoprostol to prostaglandin E2. <b>Study Design</b> We conducted a secondary analysis of women with oligohydramnios undergoing labor induction in the Consortium on Safe Labor study (2002-2008). Oligohydramnios was recorded in the medical chart. We evaluated perinatal outcomes. We limited the analysis to women with an unfavorable cervix defined by simplified Bishop score < 4. Misoprostol was compared with prostaglandin E2. Women could have received oxytocin, underwent mechanical dilation, or had artificial rupture of membranes, but women who underwent induction with both misoprostol and prostaglandin E2 were excluded. We calculated adjusted odds ratios with 95% confidence intervals, controlling for maternal age, maternal body mass index (kg/m<sup>2</sup>), parity, and mechanical dilation. <b>Results</b> Among women with oligohydramnios and an unfavorable cervix who underwent induction of labor, 141 (39.4%) received misoprostol and 217 (60.6%) received prostaglandin E2. There were no significant differences in cesarean delivery, chorioamnionitis, postpartum hemorrhage, transfusion, neonatal intensive care unit (NICU) admission, NICU stay>72 hours, mechanical ventilation, and neonatal sepsis. <b>Conclusion</b> In women with oligohydramnios and an unfavorable cervix, induction of labor with misoprostol was comparable to prostaglandin E2.

Copyright Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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