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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2017 July-August;176(7-8):419-23

DOI: 10.23736/S0393-3660.16.03399-4


language: English

Labor induction: why complicate things when they can be simple? A randomized controlled clinical trial

Amira AYACHI 1, 2 , Rim BOUCHAHDA 1, Sadok DEROUICH 1, Lassaad MKAOUER 1, 2, Mechaal MOURALI 1, 2

1 Section of Obstetrics and Gynecology, CHU Bougatfa, Bizerte, Tunisia; 2 University Tunis El Manar, Faculty of Medicine, Tunis, Tunisia


BACKGROUNDː Many different medical and mechanical methods have been used for labor induction, but the current gold standard is vaginal dinoprostone which is, unfortunately expensive, unstable, and requiring refrigerated storage. Misoprostol has been used the induction of labor since 1987. It is inexpensive, easily stored at room temperature and has few systemic side effects. So, it seems to be a very interesting alternative to dinoprostone in labor induction. The objective of our study was to compare the efficiency and safety of vaginal misoprostol with vaginal dinoprostone insert.
METHODSː A prospective, randomized, clinical trial was carried out in gynecology and obstetrics department at hospital university center in Bizerte (Tunisia). Two hundred thirteen pregnant women at term were randomized to receive every 08 hours 50 µg of misoprostol or 0.5 mg dose of dinoprostone intravaginally (maximum of 3 doses). Labor characteristics, maternal complications, and neonatal outcomes were analyzed.
RESULTSː An average labor input of 8.22 hours in the misoprostol group was significantly shorter compared to the group Dinoprostone with a delay between the onset of maturation and time childbirth significantly shorter in the misoprostol group (14.16 hours against 17.76 hours;P=0.006). The average labor time was more elongated in the dinoprostone group but the difference was not statistically significant. We also did not find difference between the two groups for birth weight of newborns, and for the Apgar score at 1 minute and 5 minutes.
CONCLUSIONSː misoprostol can provide an efficacious and safe substitute for the expensive dinoprostone.

KEY WORDS: Cervical ripening - Labor, induced - Misoprostol - Dinoprostone

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