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induction with misoprostol

Priya Sinha, Amita Suneja, Kiran Guleria, Richa Aggarwal, Neelam B Vaid
Objective: To compare the efficacy and safety of mifepristone followed by misoprostol with misoprostol alone in the management of early pregnancy failure (EPF). Study Design: A randomized double-blind placebo-controlled clinical trial. Methods: Ninety-two women with EPF ≤12 weeks were recruited and randomly allocated to receive either mifepristone 200 mg ( n  = 46) or placebo ( n  = 46). Forty-eight hours later, patients in both the groups were given 800 µg misoprostol per-vaginum...
February 2018: Journal of Obstetrics and Gynaecology of India
Caterina Neri, Alessandra Familiari, Francesco Preziosi, Chiara Vassallo, Angela Botta, Antonio Lanzone, Brigida Carducci, Alessandro Caruso
BACKGROUND: Labor induction (IOL) is one of the most common procedures performed in obstetrics, accounting for about the 20% of deliveries in the developed countries and it still represents a challenge to obstetricians. PURPOSE: The aim of this study is the comparison between two techniques for induction of Labor (IOL): oral Misoprostol and Propess. MATERIALS AND METHODS: Restrospective study in a single tertiary referral center. Clinical maternal, fetal and neonatal informations were recorded...
January 26, 2018: Minerva Ginecologica
Haitham A Torky, Heba Marie, ElSayed ElDesouky, Samy Gebreel, Osama Raslan, Asem A Moussa, Ali M Ahmad, Eman Zain, Mohamed N Mohsen
Introduction: Misoprostol is used for the medical management of miscarriage as it is more effective in the early stages of pregnancy. Letrozole has an anti-estrogen effect and is used for the pretreatment of miscarriage with misoprostol. Aim: The aim of this study was compare the efficacy and safety of letrozole with placebo pretreatment in the medical management of first trimester missed miscarriage. Design: This was a prospective randomized case-control study...
January 2018: Geburtshilfe und Frauenheilkunde
Kjersti Engen Marsdal, Ingvil Krarup Sørbye, Lise C Gaudernack, Mirjam Lukasse
BACKGROUND: Since Misoprostol Vaginal Insert (MVI - Misodel ®) was approved for labor induction in Europe in 2013, to date, no study has been published comparing MVI to Misoprostol vaginal tablets (MVT). The aim of this study, performed as part of a quality improvement project, was to compare the efficacy and safety of 200 μg MVI versus 25 μg MVT for labor induction in nulliparous women. METHODS: This retrospective cohort study included 171 nulliparous singleton term deliveries induced with MVI (n = 85) versus MVT (n = 86) at Oslo University Hospital Rikshospitalet, Norway, from November 2014 to December 2015...
January 5, 2018: BMC Pregnancy and Childbirth
Lili Sheibani, Kyle Raymond, Olof Rugarn, Deborah A Wing
OBJECTIVE: To evaluate the association between hypertensive (HTNsive) disorders of pregnancy and outcomes of labor induction, in two cohorts of women induced with either misoprostol vaginal insert (MVI) or dinoprostone vaginal insert (DVI). STUDY DESIGN: This investigation was a post-hoc analysis of data from three Phase II and III, multi-center, double blind, randomized controlled trials of women induced with identical efficacy endpoints. A competing risk framework investigated the association between HTNsive disorders of pregnancy and the time-to-event endpoints of onset of active labor and vaginal delivery...
January 1, 2018: Hypertension in Pregnancy
Carlos Benalcazar-Parra, Rogelio Monfort-Orti, Yiyao Ye-Lin, Gema Prats-Boluda, Jose Alberola-Rubio, Alfredo Perales, Javier Garcia-Casado
OBJECTIVE: The objective of this study is to compare the uterine activity response between women administered dinoprostone (prostaglandin E2) and misoprostol (prostaglandin E1) for induction of labour (IOL) by analysing not only the traditional obstetric data but also the parameters extracted from uterine electrohysterogram (EHG). METHODS: Two cohorts were defined: misoprostol (25-µg vaginal tablets; 251 women) and dinoprostone cohort (10 mg vaginal inserts; 249 women)...
December 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
Zainab Al-Ibraheemi, Lois Brustman, Brianne E Bimson, Natalie Porat, Barak Rosenn
OBJECTIVE: To test the hypothesis that cervical ripening using a combination of misoprostol and a transcervical Foley bulb leads to delivery within a shorter time compared with misoprostol alone. METHODS: This randomized controlled trial was offered to women admitted for cervical ripening. Inclusion criteria were gestational age 37 weeks or greater with intact membranes, singleton fetus, cephalic presentation, and Bishop score 6 or less. Exclusion criteria included, among others, prior uterine surgery, ruptured membranes, and any contraindication to vaginal delivery...
January 2018: Obstetrics and Gynecology
Christopher M Nash, Lauren Philp, Prakesh Shah, Kellie E Murphy
OBJECTIVE(S): The purpose of this systematic review was to evaluate the efficacy of pretreatment with letrozole prior to either a first or second trimester medical termination of pregnancy. STUDY DESIGN: We searched letrozole, femara, aromatase inhibitors, abortifacient agents, termination of pregnancy, and labour induction in MEDLINE, EMBASE, Cochrane Database, Google Scholar, and PubMed from inception of each database until September 2015 with no language limitation...
November 14, 2017: Contraception
C Lindblad Wollmann, M Ahlberg, G Petersson, S Saltvedt, O Stephansson
OBJECTIVE: Determine time-to-delivery and mode-of-delivery in labor induction among women with unripe cervix. STUDY DESIGN: 7551 nulliparous women with singleton deliveries, ⩾37 weeks, Bishop Score ⩽6, induced with dinoprostone, misoprostol or transcervical single balloon catheter. Linear regression analysis was used to estimate mean time-to-delivery with β-estimates and 95% confidence intervals with adjustments. Multivariable logistic regression analysis was used to calculate odds of cesarean delivery, instrumental vaginal delivery, maternal and neonatal outcomes...
November 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
Tove Wallstrom, Hans Jarnbert-Pettersson, David Stenson, Helena Akerud, Elisabeth Darj, Kristina Gemzell-Danielsson, Eva Wiberg-Itzel
Introduction: One great challenge in obstetric care is labor inductions. Misoprostol has advantages in being cheap and stable at room temperature and available in resource-poor settings. Material and Methods: Retrospective cohort study of 4002 singleton pregnancies with a gestational age ≥34 w at Sodersjukhuset, Stockholm, during 2009-2010 and 2012-2013. Previously used methods of labor induction were compared with misoprostol given as a solution to drink, every second hour...
2017: BioMed Research International
Somayeh Derakhshan-Aydenloo, Tahereh Behroozi-Lak, Farzaneh Broomand
BACKGROUND: Abortion, spontaneous or induced, is a common complication of pregnancy and exploration of available and safe regimens for medical abortion in developing countries seems crucial. AIMS: The present study was aimed to assess the effect of letrozole in combination with misoprostol in women eligible for legal therapeutic abortion with gestational age ≤14weeks. MATERIALS AND METHODS: This clinical randomized trial was conducted on 78 women who were candidate of medical abortion and eligible for legal abortion with gestational age ≤14 weeks that were randomly divided into two groups of case and controls...
November 6, 2017: Journal of Gynecology Obstetrics and Human Reproduction
Claire Tebbets, Diana Santana, José Ros Silvestre, Dee Redwine
INTRODUCTION: The consequences of unsafe abortion are devastating to women, their families, and their communities. Medication abortion presents an important alternative to harmful self-induction practices and surgical intervention under questionable circumstances. In settings where mifepristone is unavailable, the use of misoprostol alone is a safe and effective option for terminating an unwanted pregnancy. Studies have demonstrated the safety and efficacy of administration of misoprostol by community health workers (CHW) for indications such as postpartum hemorrhage and treatment of incomplete abortion...
October 17, 2017: Journal of Women's Health
Rafał Watrowski, Burghardt Babbel, Gerald Gitsch
Less than 10 deliveries via cervicovaginal fistula (CVF) with closed cervical os were reported so far. In the majority of cases, the patients had a history of induced abortions. The CVF was usually recognized due to postpartum hemorrhage. The facilitating role of prostaglandins used for labor induction was supposed. In all cases, the babies remained unaffected by the delivery route. We report a new case of a 37-year-old gravida 2, para 0, with a history of a paracervical tear following a first trimester abortion 11 years ago...
October 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
Jip S M Gommers, Milou Diederen, Chris Wilkinson, Deborah Turnbull, Ben W J Mol
Induction of labour is one of the most frequently applied obstetrical interventions globally. Many studies have compared the use of balloon catheters with pharmacological agents. Although the safety of the balloon catheter is often mentioned, little has been written about the total spectrum of maternal and fetal morbidity associated with induction of labour using a balloon catheter. We evaluated the safety of labour induction with a transcervical balloon catheter by conducting a literature review with pooled risk assessments of the maternal, fetal and neonatal morbidity...
November 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Joshua P Vogel, Alfred O Osoti, Anthony J Kelly, Stefania Livio, Jane E Norman, Zarko Alfirevic
BACKGROUND: Induction of labour is carried out for a variety of indications and using a range of methods. For women at low risk of pregnancy complications, some methods of induction of labour or cervical ripening may be suitable for use in outpatient settings. OBJECTIVES: To examine pharmacological and mechanical interventions to induce labour or ripen the cervix in outpatient settings in terms of effectiveness, maternal satisfaction, healthcare costs and, where information is available, safety...
September 13, 2017: Cochrane Database of Systematic Reviews
Marilyn Morris, John W Bolnga, Ovoi Verave, Jimmy Aipit, Allanie Rero, Moses Laman
BACKGROUND: Oral misoprostol as an induction of labour (IOL) agent is rapidly gaining popularity in resource-limited settings because it is cheap, stable at ambient temperatures, and logistically easier to administer compared to dinoprostone and oxytocin. We aim to investigate the safety and effectiveness of a regimen of oral misoprostol in Papua New Guinean women undergoing IOL. METHODS: As part of a prospective dose escalation study conducted at Modilon Hospital in Papua New Guinea, women with a singleton pregnancy in cephalic presentation and an unfavourable cervix who gave written informed consent were administered oral misoprostol, commencing at 25mcg once every 2 h for 4 doses and increased to 50mcg once every 2 h for 8 doses within 24 h...
September 8, 2017: BMC Pregnancy and Childbirth
Jorge Duro-Gómez, María Fernanda Garrido-Oyarzún, Ana Belén Rodríguez-Marín, Antonio Jesús de la Torre González, José Eduardo Arjona-Berral, Camil Castelo-Branco
BACKGROUND AND OBJECTIVES: To compare effectiveness and safety of dinoprostone, misoprostol and Cook's balloon as labour-inducing agents in women with intrauterine growth restriction (IUGR) at term. METHODS: Retrospective cohort chart review of women diagnosed with foetal growth restriction at term in Reina Sofia Hospital, Cordoba, Spain from January 2014 to December 2015. Registration of baseline characteristics and method of induction was made. The main outcome was time from induction to delivery...
October 2017: Archives of Gynecology and Obstetrics
Naomi Lince-Deroche, Jane Harries, Deborah Constant, Chelsea Morroni, Melanie Pleaner, Tamara Fetters, Daniel Grossman, Kelly Blanchard, Edina Sinanovic
OBJECTIVE(S): To estimate the costs of public-sector abortion provision in South Africa and to explore the potential for expanding access at reduced cost by changing the mix of technologies used. STUDY DESIGN: We conducted a budget impact analysis using public sector abortion statistics and published cost data. We estimated the total costs to the public health service over 10 years, starting in South Africa's financial year 2016/17, given four scenarios: (1) holding service provision constant, (2) expanding public sector provision, (3) changing the abortion technologies used (i...
February 2018: Contraception
Ellen Tousaw, Sweet Naw Hser Gay Moo, Grady Arnott, Angel M Foster
INTRODUCTION: The lack of economic development and longstanding conflict in Burma have led to mass population displacement. Unintended pregnancy and unsafe abortion are common and contribute to maternal death and disability. In 2011, stakeholders operating along the Thailand-Burma border established a community-based distribution program of misoprostol for early abortion, with the aim of providing safe and free abortion care in this low-resource and legally restricted setting. METHODS: We conducted 16 in-depth, in-person interviews with women from Burma residing on both sides of the border who accessed misoprostol through the community-based distribution initiative...
August 3, 2017: Contraception
Teresa Górnisiewicz, Andrzej Jaworowski, Małgorzata Zembala-Szczerba, Dorota Babczyk, Hubert Huras
OBJECTIVES: Labor-induction methods are used in about 23% of labors. Most commonly, pharmacological methods are used to pre-induct the labor with dinoprostone - a PGE2 analog, and misoprostol - a PGE1 analog. The aim of this study was to evaluate two pharmacological methods of labor induction with the use of prostaglandins applied via an intravagi-nal insert containing misoprostol at a dose of 0.2 mg and intracervical gel containing dinoprostone at a dose of 0.5 mg. MATERIAL AND METHODS: This retrospective study was conducted on a group of 50 adult patients qualified for the pre-induction of labor...
2017: Ginekologia Polska
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