Vaginal misoprostol for induction of labor: a randomized controlled trial.

Abstract:

OBJECTIVE:To evaluate the effectiveness and safety of the vaginal application of misoprostol for induction of labor at term, with the interval duration from labor induction to vaginal birth as the primary outcome measure. METHODS:Two hundred twenty-two women with indications for induction of labor at term were randomized to receive either misoprostol 50 micrograms per vagina every 4 hours as needed or our standard approach (physician-chosen combinations of intracervical or vaginal dinoprostone every 6 hours, artificial rupture of membranes, and oxytocin infusion). RESULTS:Mean (+/-standard deviation) time to vaginal delivery was 753 +/- 588 minutes for misoprostol versus 941 +/- 506 minutes for the physician-chosen combination (P = .018). Oxytocin infusion was used less frequently (relative risk [RR] 0.48, 95% confidence interval [CI] 0.31-0.74). There was no significant difference in cesarean rate or maternal morbidity. Neonatal outcomes, including cord-blood acid-base analysis, were not significantly different. The estimated cost per patient in Canadian dollars for prostaglandins was $0.22 with misoprostol and $70.00 with standard therapy. CONCLUSION:Vaginal misoprostol is a cost-effective alternative to current labor-induction protocols. We found no evidence of harm to mother or newborn in substantive outcomes.

journal_name

Obstet Gynecol

authors

Mundle WR,Young DC

doi

10.1016/0029-7844(96)00220-7

subject

Has Abstract

pub_date

1996-10-01 00:00:00

pages

521-5

issue

4 Pt 1

eissn

0029-7844

issn

1873-233X

journal_volume

88

pub_type

临床试验,杂志文章,随机对照试验
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    doi:

    authors: Pileri S,Martinelli G,Serra L,Bazzocchi F

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    pub_type: 临床试验,杂志文章,随机对照试验

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    journal_title:Obstetrics and gynecology

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    authors: Montz FJ,Horenstein J,Platt LD,d'Ablaing G,Schlaerth JB,Cunningham G

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    pub_type: 杂志文章,实务指引

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    doi:10.1016/0029-7844(95)00431-9

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    journal_title:Obstetrics and gynecology

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    doi:

    authors: Silver RK,MacGregor SN,Muhlbach LH,Kambich MP,Ragin A

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Clarke-Pearson DL,DeLong ER,Synan IS,Creasman WT

    更新日期:1984-11-01 00:00:00

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