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CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2017; 39(10): 523-528
DOI: 10.1055/s-0037-1604259
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Induction of Labor using Misoprostol in a Tertiary Hospital in the Southeast of Brazil

Indução de parto utilizando misoprostol em um hospital terciário no sudeste do Brasil
Tácito Augusto Godoy Silva
1   Mário Palmério Hospital Universitário, Universidade de Uberaba (UNIUBE), Uberaba, MG, Brazil
,
Luciano Eliziário Borges Júnior
1   Mário Palmério Hospital Universitário, Universidade de Uberaba (UNIUBE), Uberaba, MG, Brazil
,
Luisa Almeida Tahan
1   Mário Palmério Hospital Universitário, Universidade de Uberaba (UNIUBE), Uberaba, MG, Brazil
,
Taynná Ferreira Arantes Costa
1   Mário Palmério Hospital Universitário, Universidade de Uberaba (UNIUBE), Uberaba, MG, Brazil
,
Fernanda Oliveira Magalhães
1   Mário Palmério Hospital Universitário, Universidade de Uberaba (UNIUBE), Uberaba, MG, Brazil
,
Alberto Borges Peixoto
1   Mário Palmério Hospital Universitário, Universidade de Uberaba (UNIUBE), Uberaba, MG, Brazil
,
Wellington de Paula Martins
2   Department of Obstetrics and Gynecology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
,
Edward Araujo Júnior
3   Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brasil
› Author Affiliations
Further Information

Publication History

03 March 2017

30 May 2017

Publication Date:
12 July 2017 (online)

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Abstract

Purpose To assess cases of labor induction with vaginal 25-µg tablets of misoprostol and maternal outcomes in a tertiary hospital in southeastern Brazil.

Methods This was a retrospective cohort study of 412 pregnant women with indication for labor induction. Labor induction was performed with vaginal 25-µg tablets of misoprostol in pregnant women with Bishop scores < 6. Stepwise regression analysis was used to identify the factors present at the beginning of induction that could be used as predictors of successful labor induction.

Results A total of 69% of the pregnant women who underwent labor induction progressed to vaginal delivery, and 31% of the women progressed to cesarean section. One or two misoprostol tablets were used in 244 patients (59.2%). Of the 412 patients, 197 (47.8%) required oxytocin later on in the labor process, after induction with misoprostol. The stepwise regression analysis showed that only Bishop scores of 4 and 5 and previous vaginal delivery were independent factors with statistical significance in the prediction of successful vaginal labor induction (β = 0.23, p < 0.001, for a Bishop score of 4 and 5, and β = 0.22, p < 0.001, for previous vaginal delivery).

Conclusion Higher Bishop scores and previous vaginal delivery were the best predictors of successful labor induction with vaginal 25-µg tablets of misoprostol.

Resumo

Objetivo Avaliar os casos de indução do trabalho de parto com misoprostol 25 mcg por via vaginal e seus desfechos maternos em um hospital terciário do Sudeste do Brasil.

Métodos Realizou-se um estudo retrospectivo de coorte com 412 gestantes com indicações para indução de trabalho de parto. A indução do trabalho de parto foi realizada com misoprostol 25 mcg vaginal em gestantes com índice de Bishop < 6. Realizou-se análise de regressão stepwise para identificar os fatores presentes ao início da indução que poderiam ser usados como prognosticadores do sucesso da indução do trabalho de parto.

Resultados A indução de trabalho de parto determinou 69% de partos normais, sendo que 31% evoluíram para cesárea. Em relação ao número de comprimidos de misoprostol, 1 ou 2 comprimidos foram utilizados em 244 pacientes (59,2%). Das 412 pacientes, 197 (47,8%) necessitaram de ocitocina após a indução com misoprostol para dar continuidade ao trabalho de parto. Na análise de regressão stepwise, apenas a presença de índice de Bishop 4 e 5 e parto vaginal prévio foram fatores independentes com significância estatística na predição do sucesso da indução em obter parto vaginal (β = 0,23, p < 0,001, para índice de Bishop 4 e 5, e β = 0,22, p < 0,001, para parto vaginal prévio).

Conclusão Maiores índices de Bishop e parto vaginal prévio são os maiores prognosticadores do sucesso de indução de trabalho de parto com misoprostol 25 mcg vaginal.

Keywords

labor induction - misoprostol - oxytocin - cesarean sections

Palavras-chave

indução de parto - misoprostol - ocitocina - parto cesárea
 

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