Objective: To evaluate the effectiveness and safety of 25 mcg sublingual misoprostol for induction of Labor at term according to parity and membrane integrity. Methods: We conducted a prospective observational study on singleton pregnancies undergoing induction of Labor at term. Twenty-five mcg of misoprostol were administered sublingually every 4 h. Main outcomes were vaginal deliveries within 24 h, time-to-vaginal-delivery, hyper-stimulation syndrome, cesarean section rate, arterial pH< 7.0 and NICU admission rate. Results: We studied 508 patients, 375 nulliparous and 133 multiparous women. Sixty-five percent and 78%, respectively, delivered vaginally within 24 h from first administration. Median time-to-vaginal-delivery was significantly shorter in PROM than in women with intact membranes (p < 0.001). Epidural analgesia prolonged time-to-vaginal-delivery among nulliparous women (p < 0.0005). A positive correlation between BMI and time to delivery was observed in both nulliparous and multiparous women (p < 0.05). Cesarean section rate was 22% in nulliparous and 6% in multiparous group. Induction failure was 1.4% and uterine hyper-stimulation 1%. No pH≤ 7.00 was recorded; overall 7 (1.4%) newborns were admitted to NICU. Conclusions: Sublingually administered misoprostol is an effective and safe method for induction of Labor at term. Parity, status of membranes and BMI significantly affect time to delivery.
Efficacy of sublingual misoprostol for induction of labor at term and post term according to parity and membrane integrity : a prospective observational study / V. Brusati, G. Brembilla, F. Cirillo, L. Mastricci, S. Rossi, A.M. Paganelli, E. Ferrazzi. - In: THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE. - ISSN 1476-7058. - 30:5(2017), pp. 508-513.
|Titolo:||Efficacy of sublingual misoprostol for induction of labor at term and post term according to parity and membrane integrity : a prospective observational study|
|Parole Chiave:||Induction of labor; membrane status; parity; sublingual misoprostol; Administration, Sublingual; Adult; Amnion; Body Mass Index; Cesarean Section; Female; Humans; Labor, Induced; Labor, Obstetric; Misoprostol; Oxytocics; Parity; Pregnancy; Pregnancy, Prolonged; Prospective Studies; Term Birth; Time Factors; Pediatrics, Perinatology and Child Health; Obstetrics and Gynecology|
|Settore Scientifico Disciplinare:||Settore MED/40 - Ginecologia e Ostetricia|
|Data di pubblicazione:||2017|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1080/14767058.2016.1179274|
|Appare nelle tipologie:||01 - Articolo su periodico|