Vaginal misoprostol for cervical ripening and induction of labour.

Abstract:

BACKGROUND:Misoprostol (Cytotec, Searle) is a prostaglandin E1 analogue marketed for use in the prevention and treatment of peptic ulcer disease. It is inexpensive, easily stored at room temperature and has few systemic side effects. It is rapidly absorbed orally and vaginally. Although not registered for such use, misoprostol has been widely used for obstetric and gynaecological indications, such as induction of abortion and of labour. This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology. OBJECTIVES:To determine the effects of vaginal misoprostol for third trimester cervical ripening or induction of labour. SEARCH STRATEGY:The Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register and bibliographies of relevant papers. Date of last search: April 2001. SELECTION CRITERIA:The criteria for inclusion included the following: (1) clinical trials comparing vaginal misoprostol used for third trimester cervical ripening or labour induction with placebo/no treatment or other methods listed above it on a predefined list of labour induction methods; (2) random allocation to the treatment or control group; (3) adequate allocation concealment; (4) violations of allocated management not sufficient to materially affect conclusions; (5) clinically meaningful outcome measures reported; (6) data available for analysis according to the random allocation; (7) missing data insufficient to materially affect the conclusions. DATA COLLECTION AND ANALYSIS:A strategy has been developed to deal with the large volume and complexity of trial data relating to labour induction. This involved a two-stage method of data extraction. The initial data extraction was done centrally, and incorporated into a series of primary reviews arranged by methods of induction of labour, following a standardised methodology. The data will then be extracted from the primary reviews into a series of secondary reviews, arranged by category of woman. To avoid duplication of data in the primary reviews, the labour induction methods have been listed in a specific order, from one to 25. Each primary review includes comparisons between one of the methods (from two to 25) with only those methods above it on the list. MAIN RESULTS:Forty-five trials have been included. Compared to placebo, misoprostol was associated with increased cervical ripening (relative risk of unfavourable or unchanged cervix after 12 to 24 hours with misoprostol 0.09, 95% confidence interval 0.03 to 0.24). It was also associated with a reduced need for oxytocin (relative risk 0.52, 95% confidence interval 0.41 to 0.68) and reduced failure to achieve vaginal delivery within 24 hours (relative risk 0.36, 95% confidence interval 0.19 to 0.68). Uterine hyperstimulation, without fetal heart rate changes, was increased (relative risk 10.11, 95% confidence interval 1.91 to 53.6). Compared with vaginal prostaglandin E2, intracervical prostaglandin E2 and oxytocin, vaginal misoprostol labour induction resulted in fewer failures to achieve vaginal delivery within 24 hours and more uterine hyperstimulation without fetal heart rate changes. Compared with vaginal or intracervical prostaglandin E2, unchanged or unfavourable cervix after 12 to 24 hours, and oxytocin augmentation were less common with misoprostol. Compared with intracervical prostaglandin E2, uterine hyperstimulation with fetal heart rate changes and meconium stained liquor were increased and epidural analgesia was reduced. Compared with oxytocin, caesarean sections and epidural analgesia were reduced with misoprostol. Lower doses of misoprostol compared to higher doses did not show significant differences except for more need for oxytocin augmentation and less uterine hyperstimulation, with and without fetal heart rate changes. Information on women's views is conspicuously lacking. REVIEWER'S CONCLUSIONS:Although vaginal misoprostol appears to be more effective than conventional methods of cervical ripening and labour induction, the apparent increase in uterine hyperstimulation is of concern. The studies were not large enough to exclude the possibility of rare but serious adverse effects, particularly uterine rupture, which has been reported anecdotally following misoprostol use in women with and without previous caesarean section. The authors request information on cases of uterine rupture known to readers. Further research is needed to establish safety.

authors

Hofmeyr GJ,Gulmezoglu AM

doi

10.1002/14651858.CD000941

keywords:

subject

Has Abstract

pub_date

2001-01-01 00:00:00

pages

CD000941

issue

3

issn

1469-493X

pii

CD000941

pub_type

杂志文章,评审
  • Femoral nerve blocks for acute postoperative pain after knee replacement surgery.

    abstract:BACKGROUND:Total knee replacement (TKR) is a common and often painful operation. Femoral nerve block (FNB) is frequently used for postoperative analgesia. OBJECTIVES:To evaluate the benefits and risks of FNB used as a postoperative analgesic technique relative to other analgesic techniques among adults undergoing TKR....

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009941.pub2

    authors: Chan EY,Fransen M,Parker DA,Assam PN,Chua N

    更新日期:2014-05-13 00:00:00

  • Selective serotonin re-uptake inhibitors (SSRIs) for preventing migraine and tension-type headaches.

    abstract:BACKGROUND:Headache is a common medical problem. In view of recent discoveries about the role of serotonin in pain mechanisms, selective serotonin re-uptake inhibitors (SSRIs) have been evaluated for the prevention of migraine and tension-type headaches (TTH). OBJECTIVES:To evaluate the efficacy and tolerability of SS...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002919.pub2

    authors: Moja PL,Cusi C,Sterzi RR,Canepari C

    更新日期:2005-07-20 00:00:00

  • Interventions for preventing high altitude illness: Part 1. Commonly-used classes of drugs.

    abstract:BACKGROUND:High altitude illness (HAI) is a term used to describe a group of cerebral and pulmonary syndromes that can occur during travel to elevations above 2500 metres (8202 feet). Acute hypoxia, acute mountain sickness (AMS), high altitude cerebral oedema (HACE) and high altitude pulmonary oedema (HAPE) are reporte...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009761.pub2

    authors: Nieto Estrada VH,Molano Franco D,Medina RD,Gonzalez Garay AG,Martí-Carvajal AJ,Arevalo-Rodriguez I

    更新日期:2017-06-27 00:00:00

  • Allergen-specific oral immunotherapy for peanut allergy.

    abstract:BACKGROUND:Peanut allergy is one of the most common forms of food allergy encountered in clinical practice.  In most cases, it does not spontaneously resolve; furthermore, it is frequently implicated in acute life-threatening reactions. The current management of peanut allergy centres on meticulous avoidance of peanuts...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009014.pub2

    authors: Nurmatov U,Venderbosch I,Devereux G,Simons FE,Sheikh A

    更新日期:2012-09-12 00:00:00

  • Ibuprofen for the treatment of patent ductus arteriosus in preterm and/or low birth weight infants.

    abstract:BACKGROUND:A patent ductus arteriosus (PDA) complicates the clinical course of preterm infants, increasing their risks of developing chronic lung disease (CLD), necrotizing enterocolitis (NEC), and intraventricular hemorrhage (IVH). Indomethacin is used as standard therapy to close a PDA, but is associated with reduced...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003481.pub3

    authors: Ohlsson A,Walia R,Shah S

    更新日期:2008-01-23 00:00:00

  • Antidepressant drugs for narcolepsy.

    abstract:BACKGROUND:Narcolepsy is a disorder of the central nervous system, the main symptoms of which are excessive daytime sleepiness (EDS) and cataplexy (an abrupt and reversible decrease in or loss of muscle tone, affecting the limbs or trunk or both, elicited by emotional stimuli). Narcolepsy has an adverse impact on peopl...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003724.pub3

    authors: Vignatelli L,D'Alessandro R,Candelise L

    更新日期:2008-01-23 00:00:00

  • Diet or exercise, or both, for weight reduction in women after childbirth.

    abstract:BACKGROUND:Weight retention after pregnancy may contribute to obesity. It is known that diet and exercise are recommended components of any weight loss programme in the general population. However, strategies to achieve healthy body weight among postpartum women have not been adequately evaluated. OBJECTIVES:The objec...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005627.pub2

    authors: Amorim AR,Linne YM,Lourenco PM

    更新日期:2007-07-18 00:00:00

  • Omega 3 fatty acid for the prevention of cognitive decline and dementia.

    abstract:BACKGROUND:Evidence from observational studies suggests that diets high in omega-3 long-chain polyunsaturated fatty acids (PUFA) may protect people from cognitive decline and dementia. The strength of this potential protective effect has recently been tested in randomised controlled trials. OBJECTIVES:To assess the ef...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005379.pub3

    authors: Sydenham E,Dangour AD,Lim WS

    更新日期:2012-06-13 00:00:00

  • Medical and surgical treatment for ocular myasthenia.

    abstract:BACKGROUND:Approximately 50% of people with myasthenia gravis present with purely ocular symptoms, so called ocular myasthenia. Of these between 50% to 60% develop generalized disease, most within two years. Their management is controversial. This is an update of a review first published in 2006 and previously updated ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005081.pub3

    authors: Benatar M,Kaminski H

    更新日期:2012-12-12 00:00:00

  • Interventions for rosacea.

    abstract:BACKGROUND:Rosacea is a common skin condition affecting the face, characterised by flushing, redness, pimples, pustules and dilated blood vessels. The eyes are often also involved. The cause of rosacea is unclear. It is a chronic disease, which can be controlled in most cases with appropriate treatment. Numerous treatm...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003262.pub2

    authors: van Zuuren EJ,Graber MA,Hollis S,Chaudhry M,Gupta AK

    更新日期:2004-01-01 00:00:00

  • First aid interventions by laypeople for acute oral poisoning.

    abstract:BACKGROUND:Oral poisoning is a major cause of mortality and disability worldwide, with estimates of over 100,000 deaths due to unintentional poisoning each year and an overrepresentation of children below five years of age. Any effective intervention that laypeople can apply to limit or delay uptake or to evacuate, dil...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD013230

    authors: Avau B,Borra V,Vanhove AC,Vandekerckhove P,De Paepe P,De Buck E

    更新日期:2018-12-19 00:00:00

  • Medical and surgical interventions for the treatment of usual-type vulval intraepithelial neoplasia.

    abstract:BACKGROUND:Usual-type vulval intraepithelial neoplasia (uVIN) is a pre-cancerous condition of the vulval skin. Also known as high-grade VIN, VIN 2/3 or high-grade vulval squamous intraepithelial lesion (HSIL), uVIN is associated with high-risk subtype human papilloma virus (HPV) infection. The condition causes distress...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD011837.pub2

    authors: Lawrie TA,Nordin A,Chakrabarti M,Bryant A,Kaushik S,Pepas L

    更新日期:2016-01-05 00:00:00

  • Controlled hypotension versus normotensive resuscitation strategy for people with ruptured abdominal aortic aneurysm.

    abstract:BACKGROUND:An abdominal aortic aneurysm (AAA) is the pathological enlargement of the aorta and can develop in both men and women. Progressive aneurysm enlargement can lead to rupture. The rupture of an AAA is frequently fatal and accounts for the death from haemorrhagic shock of at least 45 people per 100,000 populatio...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD011664.pub3

    authors: Moreno DH,Cacione DG,Baptista-Silva JC

    更新日期:2018-06-13 00:00:00

  • WITHDRAWN: Acupuncture for neck disorders.

    abstract:BACKGROUND:Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Treatments for neck pain are varied, as are perceptions of benefit. Acupuncture has been used as an alternative to more conventional treatment for musculoskeletal pain. This review summarises the most current sci...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004870.pub5

    authors: Trinh K,Graham N,Irnich D,Cameron ID,Forget M

    更新日期:2016-11-17 00:00:00

  • Aripiprazole versus other atypical antipsychotics for schizophrenia.

    abstract:BACKGROUND:In most western industrialised countries, second generation (atypical) antipsychotics are recommended as first line drug treatments for people with schizophrenia. In this review we specifically examine how the efficacy and tolerability of one such agent - aripiprazole - differs from that of other comparable ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006569.pub4

    authors: Khanna P,Komossa K,Rummel-Kluge C,Hunger H,Schwarz S,El-Sayeh HG,Leucht S

    更新日期:2013-02-28 00:00:00

  • Botulinum toxin for myofascial pain syndromes in adults.

    abstract:BACKGROUND:Myofascial pain syndrome (MPS) is a regional muscular pain syndrome characterised by the presence of trigger points, which are painful points in one or more muscles. The pain can be felt at the site where the trigger point is located or it can be felt away from that place when the muscle is pressed (referred...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007533.pub2

    authors: Soares A,Andriolo RB,Atallah AN,da Silva EM

    更新日期:2012-04-18 00:00:00

  • Interventions for atrophic rhinitis.

    abstract:BACKGROUND:Atrophic rhinitis is a chronic nasal pathology characterised by the formation of thick dry crusts in a roomy nasal cavity, which has resulted from progressive atrophy of the nasal mucosa and underlying bone. The common symptoms may include foetor, ozaena, crusting/nasal obstruction, epistaxis, anosmia/cacosm...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD008280.pub2

    authors: Mishra A,Kawatra R,Gola M

    更新日期:2012-02-15 00:00:00

  • Touch therapies for pain relief in adults.

    abstract:BACKGROUND:Pain is a global public health problem affecting the lives of large numbers of patients and their families. Touch therapies (Healing Touch (HT), Therapeutic Touch (TT) and Reiki) have been found to relieve pain, but some reviews have suggested there is insufficient evidence to support their use. OBJECTIVES:...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006535.pub2

    authors: So PS,Jiang Y,Qin Y

    更新日期:2008-10-08 00:00:00

  • Carbamazepine for schizophrenia.

    abstract:BACKGROUND:Many people with schizophrenia do not achieve a satisfactory treatment response with just antipsychotic drug treatment and various adjunct medications are used to promote additional response. The antiepileptic carbamazepine is one such drug. OBJECTIVES:To evaluate the effects of carbamazepine and its deriva...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001258.pub2

    authors: Leucht S,Kissling W,McGrath J,White P

    更新日期:2007-07-18 00:00:00

  • Periurethral injection therapy for urinary incontinence in women.

    abstract:BACKGROUND:Periurethral or transurethral injection of bulking agents is a surgical procedure most often used for the treatment of stress urinary incontinence a common, troublesome symptom amongst adult women. OBJECTIVES:To assess the effects of periurethral/transurethral injection therapy in the treatment of urinary i...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003881.pub2

    authors: Keegan PE,Atiemo K,Cody J,McClinton S,Pickard R

    更新日期:2007-07-18 00:00:00

  • Epinephrine for bronchiolitis.

    abstract:BACKGROUND:Bronchodilators are commonly used for acute bronchiolitis, despite uncertain effectiveness. OBJECTIVES:To examine the efficacy and safety of epinephrine in children less than two with acute viral bronchiolitis. SEARCH STRATEGY:We searched CENTRAL (2010, Issue 3) which contains the Acute Respiratory Infecti...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003123.pub3

    authors: Hartling L,Bialy LM,Vandermeer B,Tjosvold L,Johnson DW,Plint AC,Klassen TP,Patel H,Fernandes RM

    更新日期:2011-06-15 00:00:00

  • Heparin, low molecular weight heparin and physical methods for preventing deep vein thrombosis and pulmonary embolism following surgery for hip fractures.

    abstract:BACKGROUND:Hip fracture patients have a high risk of thrombo-embolic complications following surgical management. OBJECTIVES:To examine the effects of heparin (unfractionated (U), and low molecular weight (LMW) heparins), and physical methods (compression stockings, calf or foot pumps) for prevention of deep venous th...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000305

    authors: Handoll HH,Farrar MJ,McBirnie J,Tytherleigh-Strong G,Milne AA,Gillespie WJ

    更新日期:2002-01-01 00:00:00

  • Endoscopic pneumatic dilation versus botulinum toxin injection in the management of primary achalasia.

    abstract:BACKGROUND:Achalasia is an oesophageal motility disorder, of unknown cause, which results in increased lower oesophageal sphincter (LOS) tone and symptoms of difficulty swallowing. Treatments are aimed at reducing the LOS tone. Current endoscopic therapeutic options include pneumatic dilation (PD) or botulinum toxin (B...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005046.pub3

    authors: Leyden JE,Moss AC,MacMathuna P

    更新日期:2014-01-01 00:00:00

  • Adjuvant radiotherapy for stage I endometrial cancer.

    abstract:BACKGROUND:This is an updated version of the original Cochrane review published in Issue 2, 2007. The role of radiotherapy (both pelvic external beam radiotherapy (EBRT) and vaginal intracavity brachytherapy (VBT)) in stage I endometrial cancer following hysterectomy remains controversial. OBJECTIVES:To assess the eff...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003916.pub3

    authors: Kong A,Johnson N,Kitchener HC,Lawrie TA

    更新日期:2012-03-14 00:00:00

  • Bypass surgery for chronic lower limb ischaemia.

    abstract:BACKGROUND:Bypass surgery is one of the mainstay treatments for patients with critical lower limb ischaemia (CLI). This is the second update of the review first published in 2000. OBJECTIVES:To assess the effects of bypass surgery in patients with chronic lower limb ischaemia. SEARCH METHODS:For this update, the Coch...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002000.pub3

    authors: Antoniou GA,Georgiadis GS,Antoniou SA,Makar RR,Smout JD,Torella F

    更新日期:2017-04-03 00:00:00

  • Diclofenac with or without an antiemetic for acute migraine headaches in adults.

    abstract:BACKGROUND:This review is an update of a previously published review in Issue 2, 2012 (Derry 2012a). Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter (OTC) analgesic...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008783.pub3

    authors: Derry S,Rabbie R,Moore RA

    更新日期:2013-04-30 00:00:00

  • Dietary fibre for the prevention of colorectal adenomas and carcinomas.

    abstract:BACKGROUND:Colorectal cancer (CRC) is a major cause of morbidity and mortality in industrialized countries. Experimental evidence has supported the hypothesis that dietary fibre may be protective for the development of CRC, although epidemiologic data have been inconclusive. OBJECTIVES:We have conducted a systematic r...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003430

    authors: Asano T,McLeod RS

    更新日期:2002-01-01 00:00:00

  • Opioids for neonates receiving mechanical ventilation.

    abstract:BACKGROUND:Mechanical ventilation is a potentially painful and discomforting intervention widely used in neonatal intensive care units. Newborn babies (neonates) demonstrate increased sensitivity to pain, which may affect clinical and neurodevelopmental outcomes. The use of drugs that reduce pain might be important in ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004212.pub3

    authors: Bellù R,de Waal KA,Zanini R

    更新日期:2008-01-23 00:00:00

  • Psychosocial interventions for preventing and treating depression in dialysis patients.

    abstract:BACKGROUND:People with end-stage kidney disease (ESKD) treated with dialysis are frequently affected by major depression. Dialysis patients have prioritised depression as a critically important clinical outcome in nephrology trials. Psychological and social support are potential treatments for depression, although a Co...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD004542.pub3

    authors: Natale P,Palmer SC,Ruospo M,Saglimbene VM,Rabindranath KS,Strippoli GF

    更新日期:2019-12-02 00:00:00

  • Neuromuscular paralysis for newborn infants receiving mechanical ventilation.

    abstract:BACKGROUND:Ventilated newborn infants breathing in asynchrony with the ventilator are at risk for complications during mechanical ventilation, such as pneumothorax or intraventricular hemorrhage, and are exposed to more severe barotrauma, which consequently could impair their clinical outcome. Neuromuscular paralysis, ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002773

    authors: Cools F,Offringa M

    更新日期:2000-01-01 00:00:00