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Notice bibliographique (sans auteurs) :

Cardiotocographic abnormalities associated with misoprostol and dinoprostone cervical ripening and labor induction - European Journal of Obstetrics Gynecology and Reproductive Biology - Vol. 156, 2 - p.144-148

Auteur·e(s) :

Pevzner, L.; Alfirevic, Z.; Powers, B.L.; Wing, D.A.

Année de publication :

2011

URL(s) :

https://www.scopus.com/inward/record.uri?eid=2-s2.…
https://doi.org/10.1016/j.ejogrb.2011.01.015

Résumé (français)  :

Abstract (English)  :

Objective: To characterize the incidence and timing of cardiotocographic (CTG) abnormalities associated with misoprostol and dinoprostone vaginal inserts during labor induction. Study design: This was a secondary analysis of data collected during the misoprostol vaginal insert (MVI) trial, a multi-site, double-masked, randomized trial of women requiring cervical ripening before induction of labor. The timing, incidence and clinical outcomes associated with CTG abnormalities were analyzed among three study groups. Results: 1308 subjects were randomized to receive dinoprostone pessary, misoprostol 50 mcg (MVI 50) or 100 mcg (MVI 100) vaginal insert. 6.8% of MVI 50-treated women had a uterine contractile abnormality (hyperstimulation, hypertonus and/or tachysystole) while the study drug was in situ, compared to 17.4% with dinoprostone insert (p < 0.001) and 17.3% with MVI 100 (p < 0.001). There was no significant difference in incidence of fetal heart rate (FHR) abnormalities that occurred with the study drug - 11.2% with dinoprostone, compared to 9.9% with MVI 50 and 10.7% with MVI 100. Cardiotocographic (CTG) abnormalities while the study drug was in situ occurred later in women treated with MVI 50 (7.5 h [6.2-9.8]) compared to dinoprostone (5.5 h [4.2-6.6], p = 0.003) and MVI 100 (7.0 h [5.7-7.9], p = 0.13). Eight participants in MVI 50 group underwent cesarean section secondary to a CTG event that was initially noted with the study drug in situ, compared to eight dinoprostone-treated participants and 16 in the MVI 100 group, but these differences were not statistically significant. Conclusion: Cardiotocographic abnormalities were less frequent and occurred after longer exposure with MVI 50 than MVI 100 or dinoprostone. Clinical outcomes were similar among the groups. © 2011 Elsevier Ireland Ltd. All rights reserved.

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Mots-clés :

➡ déclenchement ; maturation du col ; misoprostol (Cytotec)

Auteur·e de cette fiche :

Import 26/11/2017 — 26 Nov 2017
➡ dernière modification : Bernard Bel — 26 Nov 2017