<strong>Objective:</strong><span><span style="font-family:Verdana;"> Misoprostol vaginal insert (MVI) is proven to induce labor by a </span><span style="font-family:Verd...<strong>Objective:</strong><span><span style="font-family:Verdana;"> Misoprostol vaginal insert (MVI) is proven to induce labor by a </span><span style="font-family:Verdana;">continuously release of PGE1. Previous reports showed that MVI reduced</span><span style="font-family:Verdana;"> induction to delivery time as well as active labor time but it also increased uterine tachysystole. Here we attempted to clarify whether MVI is safe and </span><span style="font-family:Verdana;">efficient for women with pregnancies >40 weeks in a single institute.</span> <b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This study was performed in Lutheran Hospital Bergisch Gladbach, Germany 2014-2019. A total of 304 women between 40 + 0 to 42 + 0 weeks underwent labor induction with MVI. Outcomes were</span></span><span style="font-family:Verdana;">:</span><span><span style="font-family:Verdana;"> 1) maternal: time from insertion </span><span style="font-family:Verdana;">to delivery, interventions, mode of delivery, and uterine tachysystole, 2)</span><span style="font-family:Verdana;"> neo</span></span><span style="font-family:Verdana;">-</span><span><span style="font-family:Verdana;">natal: cord blood pH, APGAR scores, and admission to a neonatal clinic. This </span><span style="font-family:Verdana;">study ended unexpectedly due to the withdrawal of MVI (Misodel<span style="white-space:nowrap;"><sup>TM</sup></span>) in</span><span style="font-family:Verdana;"> September 2019. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">75.7% (n = 230) of women gave birth within 24 hours after MVI placement. 72.2% (n = 140) nulliparous women and 81.8% (n = 90) </span><span style="font-family:Verdana;">parous women delivered within 24 hours. In two cases emergency CS was</span><span style="font-family:Verdana;"> required. 67.8% (n = 206) of women delivered vaginal. 2.3% (n = 7) of cord pH levels were below 7.10. 3.3% (n = 10) of newborns were transmitted to a neonatal clinic. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">MVI is an efficient method to induce labor for </span><span style="font-family:Verdana;">pregnant women beyond 40 + 0 weeks. However, considering various</span><span style="font-family:Verdana;"> compli</span><span style="font-family:Verdana;">cations observed (uterine tachysystole and fetal distress leading to a high</span><span style="font-family:Verdana;"> number of CS), we cannot universally advocate the use of MVI.</span></span>展开更多
文摘<strong>Objective:</strong><span><span style="font-family:Verdana;"> Misoprostol vaginal insert (MVI) is proven to induce labor by a </span><span style="font-family:Verdana;">continuously release of PGE1. Previous reports showed that MVI reduced</span><span style="font-family:Verdana;"> induction to delivery time as well as active labor time but it also increased uterine tachysystole. Here we attempted to clarify whether MVI is safe and </span><span style="font-family:Verdana;">efficient for women with pregnancies >40 weeks in a single institute.</span> <b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This study was performed in Lutheran Hospital Bergisch Gladbach, Germany 2014-2019. A total of 304 women between 40 + 0 to 42 + 0 weeks underwent labor induction with MVI. Outcomes were</span></span><span style="font-family:Verdana;">:</span><span><span style="font-family:Verdana;"> 1) maternal: time from insertion </span><span style="font-family:Verdana;">to delivery, interventions, mode of delivery, and uterine tachysystole, 2)</span><span style="font-family:Verdana;"> neo</span></span><span style="font-family:Verdana;">-</span><span><span style="font-family:Verdana;">natal: cord blood pH, APGAR scores, and admission to a neonatal clinic. This </span><span style="font-family:Verdana;">study ended unexpectedly due to the withdrawal of MVI (Misodel<span style="white-space:nowrap;"><sup>TM</sup></span>) in</span><span style="font-family:Verdana;"> September 2019. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">75.7% (n = 230) of women gave birth within 24 hours after MVI placement. 72.2% (n = 140) nulliparous women and 81.8% (n = 90) </span><span style="font-family:Verdana;">parous women delivered within 24 hours. In two cases emergency CS was</span><span style="font-family:Verdana;"> required. 67.8% (n = 206) of women delivered vaginal. 2.3% (n = 7) of cord pH levels were below 7.10. 3.3% (n = 10) of newborns were transmitted to a neonatal clinic. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">MVI is an efficient method to induce labor for </span><span style="font-family:Verdana;">pregnant women beyond 40 + 0 weeks. However, considering various</span><span style="font-family:Verdana;"> compli</span><span style="font-family:Verdana;">cations observed (uterine tachysystole and fetal distress leading to a high</span><span style="font-family:Verdana;"> number of CS), we cannot universally advocate the use of MVI.</span></span>
