Efficacy and safety of oral misoprostol 25 mu g vs. vaginal dinoprostone in induction of labor at term
Résumé
Objective. - To compare the efficacy and safety of oral misoprostol 25 mu g compared to vaginal dinoprostone in the induction of labor at term.& nbsp;Methods. - Analytic, retrospective study of patients induced at term by prostaglandins with an unfavorable cervix, over two consecutive periods from 01/01/2019 to 19/02/2020 and from 20/02/2020 to 07/04/2021, within a regional level III university hospital center. We compared the safety and the efficacy between the oral misoprostol Angusta1 used since 20/02/2020 and the vaginal dinoprostone previously used in gel or diffuser. The primary endpoint was the rate of vaginal deliveries within 24 h. Secondary endpoints were cesarean section rate, indications for cesarean section, uterine contractility abnormalities and neonatal outcomes.& nbsp;Results. - Our study found no difference in terms of efficacy with similar rates of vaginal deliveries within 24 h (51.88% vs. 51.25%; P = 0.87) and caesarean sections (misoprostol group: 19.42% vs. dinoprostone group: 16.62%; P = 0.33). However, the tolerance criteria revealed in the dinoprostone group an increase in tachysystole (misoprostol group: 9.28% vs. dinoprostone group: 16.90%; P = 0.003) and acidosis (arterial pH < 7.10, misoprostol group: 3.83% vs. dinoprostone group: 9.29%; P = 0.006).& nbsp;Conclusion. - No difference in efficacy was found between the two induction techniques. Oral misoprostol 25 mu g seems to be better tolerated from a maternal and fetal point of view. (c) 2021 Elsevier Masson SAS. All rights reserved.