Maternal and neonatal outcome of labour induction at term comparing two regimens

To compare the efficacy and safety of two misoprostol dosing regimens for induction of labour in primiparous (1P) and multiparous (>1P) women. METHODS Retrospective study of induction of labour using vaginal misoprostol 25 �g vs. 50 �g every 6 h in 942 women at a tertiary centre. The main outcome variables are induction-to-delivery interval, latency period duration, vaginal delivery within 24 h, and maternal and foetal safety outcome. RESULTS With the 50 �g regimen, induction-to-delivery intervals were significantly shorter: 18.4 h vs. 24.6 h (1P) and 14 h vs. 17.9 h (>1P), as was latency period duration (by 5.4 and 4 h, respectively). Vaginal delivery within 24 h was significantly more frequent, as were non-reassuring foetal heart rate (1P: 20% vs. 14%) and tachysystole (1P: 31% vs. 11%; >1P: 21% vs. 7%). No uterine rupture was reported. Neonatal outcomes were similar except for significantly more frequent infant referral to neonatal intensive care in the >1P group receiving the 50 �g regimen (11% vs. 4%). CONCLUSION Vaginal misoprostol 25 �g seems to maintain efficacy with more acceptable maternal and neonatal safety. As induction of labour is an off-label use for misoprostol, safety should be prioritised with the lower dosage regimen despite the longer induction-to-delivery interval. DOI: https://doi.org/10.1515/jpm-2013-0215 Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-99479 Published Version Originally published at: Kreft, Martina; Krähenmann, Franziska; Roos, Malgorzata; Kurmanavicius, Juozas; Zimmermann, Roland; Ochsenbein-Kölble, Nicole (2014). Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol. Journal of Perinatal Medicine, 42(5):603-609. DOI: https://doi.org/10.1515/jpm-2013-0215 DOI 10.1515/jpm-2013-0215 J. Perinat. Med. 2014; aop Martina Kreft , Franziska Kr ä henmann , Malgorzata Roos , Juozas Kurmanavicius , Roland Zimmermann and Nicole Ochsenbein-K ö lble * Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol