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Créée le : 28 Mar 2006
Modifiée le : 02 Dec 2007

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Notice bibliographique (sans auteurs) :

Induction of labor in great grandmultipara with misoprostol. {Turquie}. Eur J Obstet Gynecol Reprod Biol. 2005 Aug 26;[Epub ahead of print]

Auteur·e(s) :

Zeteroglu S, Sahin HG, Sahin HA.

Année de publication :

2005

URL(s) :

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE:: To compare the efficacy and complications of intravaginal misoprostol application with oxytocin infusion for induction of labor in great grandmultiparous pregnancies with a Bishop score of <6.

STUDY DESIGN:: Sixty-four great grandmultiparous (delivering the tenth, or greater, infant) pregnant patients with a Bishop score of <6 were randomized in two groups with 32 patients receiving 50mug intravaginal misoprostol four times with 4h intervals, and 32 patients receiving oxytocin infusion for induction of labor starting from 2mIU/min, increasing it every 30min with 2mIU/min increments up to maximum of 40mIU/min. The time from induction to delivery, the route of delivery, fetal outcome and maternal complications were recorded. Statistical analyses were performed using Mann-Whitney U-test, Chi-Square test and hypothesis test about differences for two proportions (t-test) to determine differences between the two groups. P</=0.05 was considered significant.

RESULT:: The mean time from induction to delivery was 9.91+/-4.30 and 10.88+/-4.72h in the misoprostol and oxytocin administered group, respectively, with no significant difference between the groups. The rate of vaginal delivery was 84.4 and 87.5% in the misoprostol and oxytocin administered group, respectively, with no significant difference between the groups (P=0.72). The rates of placental abruption and postpartum hemorrhage were similar in both groups and no case of uterine rupture occurred. The 1 and 5min mean Apgar scores were 6.91+/-1.57-8.88+/-1.39 and 7.22+/-1.24-9.06+/-0.84 in the misoprostol and oxytocin administered group with no significant differences between the groups (P=0.38 and 0.51). No case of asphyxia was present. The rate of admission to neonatal intensive care unit was higher in the misoprostol administered group, but the difference was not significant.

CONCLUSION:: Intravaginal misoprostol is an alternative method to oxytocin in induction of labor in great grandmultiparous pregnant women with low Bishop scores, as it is effective, cheap and easy to use. Safety about rare complications and neonatal morbidity needs clarifications with further studies.

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Mots-clés :

➡ médecine factuelle ; déclenchement ; détresse fœtale ; hémorragie postpartum ; misoprostol (Cytotec) ; ocytocine (Syntocinon) ; dépassement de terme

Auteur·e de cette fiche :

Cécile Loup — 28 Mar 2006