Efficacy and safety of oral misoprostol vs transvaginal balloon catheter for labor induction: An observational study within the SWEdish Postterm Induction Study (SWEPIS)
| Autor: | Ulla-Britt Wennerholm, Lars Ladfors, Helena Fadl, Henrik Hagberg, Sissel Saltvedt, Verena Sengpiel, Anna-Karin Wikström, Sophia Brismar Wendel, Helen Elden, Ylva Carlsson, Mårten Alkmark, Maria Jonsson, Anna Wessberg |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Catheters medicine.medical_treatment Bishop score Gestational Age Reproduktionsmedicin och gynekologi psychology 03 medical and health sciences 0302 clinical medicine Pregnancy Oxytocics Surveys and Questionnaires Obstetrics Gynecology and Reproductive Medicine medicine Humans Childbirth Labor Induced 030212 general & internal medicine humans Postterm pregnancy Misoprostol Sweden misoprostol pregnancy outcome 030219 obstetrics & reproductive medicine Obstetrics Vaginal delivery business.industry Pregnancy Outcome Balloon catheter Obstetrics and Gynecology Prenatal Care General Medicine medicine.disease mothers Labor induction Gestation Female labor induction business pregnancy prolonged Cervical Ripening medicine.drug |
| Zdroj: | Acta Obstetricia et Gynecologica Scandinavica. 100:1463-1477 |
| ISSN: | 1600-0412 0001-6349 |
| DOI: | 10.1111/aogs.14155 |
| Popis: | Introduction Induction of labor is increasing. A common indication for induction of labor is late term and postterm pregnancy at 41 weeks or more. We aimed to evaluate if there are any differences regarding efficacy, safety, and women's childbirth experience between oral misoprostol and transvaginal balloon catheter for cervical ripening in women with a low-risk singleton pregnancy and induction of labor at 41+0 to 42+0 to 1 weeks of gestation. Material and methods In this observational study, based on data from the Swedish Postterm Induction Study (SWEPIS), a multicenter randomized controlled trial, a total of 1213 women with a low-risk singleton pregnancy at 41 to 42 weeks of gestation were induced with oral misoprostol (n = 744) or transvaginal balloon catheter (n = 469) at 15 Swedish delivery hospitals. The primary efficacy outcome was vaginal delivery within 24 h and primary safety outcomes were neonatal and maternal composite adverse outcomes. Secondary outcomes included time to vaginal delivery and mode of delivery. Women's childbirth experience was assessed with the Childbirth Experience Questionnaire (CEQ 2.0) and visual analog scale. We present crude and adjusted mean differences and relative risks (RR) with 95% CI. Adjustment was performed for a propensity score based on delivery hospital and baseline characteristics including Bishop score. Results Vaginal delivery within 24 h was significantly lower in the misoprostol group compared with the balloon catheter group (46.5% [346/744] versus 62.7% [294/469]; adjusted RR 0.76 95% CI 0.640.89]). Primary neonatal and maternal safety outcomes did not differ between groups (neonatal composite 3.5% [36/744] vs 3.2% [15/469]; adjusted RR 0.77 [95% CI 0.31-1.89]; maternal composite 2.3% [17/744] versus 1.9% [9/469]; adjusted RR 1.70 [95% CI 0.58-4.97]). Adjusted mean time to vaginal delivery was increased by 3.8 h (95% CI 1.3-6.2 h) in the misoprostol group. Non-operative vaginal delivery and cesarean delivery rates did not differ. Women's childbirth experience was positive overall and similar in both groups. Conclusion Induction of labor with oral misoprostol compared with a transvaginal balloon catheter was associated with a lower probability of vaginal delivery within 24 h and a longer time to vaginal delivery. However, primary safety outcomes, non-operative vaginal delivery, and women's childbirth experience were similar in both groups. Therefore, both methods can be recommended in women with low-risk postdate pregnancies. |
| Databáze: | OpenAIRE |
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