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Created on : 01 Feb 2006
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Misoprostol induction of labor among women with a history of cesarean delivery. {USA}. Am J Obstet Gynecol. 2001 May;184(6):1115-7.

Author(s) :

Choy-Hee L, Raynor BD.

Year of publication :


URL(s) :…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: Several reports have appeared of uterine rupture among women with a history of cesarean delivery who received misoprostol for induction of labor. A recent review suggested a uterine rupture rate of almost 6%, but the experience at our institution did not seem to reflect this high complication rate. This study was undertaken to compare complications of labor induction with misoprostol between women with a history of cesarean delivery and women without uterine scarring.

STUDY DESIGN: A computerized database was used to select women with a viable fetus who underwent induction of labor with misoprostol during the period from January 1996 through December 1998. Patients were given 50 microg misoprostol every 4 hours. Women with a history of cesarean delivery were retrospectively compared with those without uterine scarring.

RESULTS: A total of 425 women were given misoprostol for induction of labor: 48 had a history of cesarean delivery and 377 did not. Women with a history of cesarean delivery were more likely to be delivered abdominally (56% vs 28%; P <.04). Among women with a history of cesarean delivery, women who had a history of vaginal birth after cesarean were more likely to be delivered vaginally (92% vs 42%; P =.003). There was no difference in the overall rate of complications (2% with scarring vs 3% without scarring). There were no uterine ruptures. However, the previous cesarean group was more likely than the unscarred group to have blood loss >500 mL (38% vs 22%; P <.03). Although the incidences of fetal distress were similar, neonates born to women in the previous cesarean group were more likely to have an Apgar score <7 at 5 minutes (13% vs 5%; P <.04).

CONCLUSION: Misoprostol induction of labor in women with a history of cesarean resulted in a higher rate of cesarean delivery than was seen among women without uterine scarring but was not associated with a higher incidence of complications. There were no uterine ruptures in either group.

Sumário (português)  :

Resumen (español)  :

Comments :

Fiche importée de avec l’aide de Ken Turkowski, septembre 2005

Argument (français) :

Argument (English):

Argumento (português):

Argumento (español):

Keywords :

➡ vaginal birth after caesarean ; c-section/caesarean ; evidence-based medicine/midwifery ; induction of labor ; fetal distress ; postpartum hemorrhage ; misoprostol (Cytotec) ; post-term pregnancy

Author of this record :

Cécile Loup — 01 Feb 2006

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