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Am J Perinatol 2017; 34(02): 204-210
DOI: 10.1055/s-0036-1585418
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Induction of Labor in Women with Oligohydramnios: Misoprostol Compared with Prostaglandin E2

Tetsuya Kawakita
1   Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia
,
Katherine L. Grantz
1   Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia
,
Helain J. Landy
2   Department of Obstetrics and Gynecology, MedStar Georgetown University Hospital, Washington, District of Columbia
,
Chun-Chih Huang
3   Department of Biostatistics and Epidemiology, MedStar Health Research Institute, Hyattsville, Maryland
4   Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, District of Columbia
,
Michelle A. Kominiarek
5   Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
› Author Affiliations
Further Information

Publication History

17 March 2016

08 June 2016

Publication Date:
11 July 2016 (online)

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Abstract

Objective To compare perinatal outcomes in women with oligohydramnios and an unfavorable cervix undergoing labor induction with misoprostol to prostaglandin E2.

Study Design We conducted a secondary analysis of women with oligohydramnios undergoing labor induction in the Consortium on Safe Labor study (2002–2008). Oligohydramnios was recorded in the medical chart. We evaluated perinatal outcomes. We limited the analysis to women with an unfavorable cervix defined by simplified Bishop score ≤ 4. Misoprostol was compared with prostaglandin E2. Women could have received oxytocin, underwent mechanical dilation, or had artificial rupture of membranes, but women who underwent induction with both misoprostol and prostaglandin E2 were excluded. We calculated adjusted odds ratios with 95% confidence intervals, controlling for maternal age, maternal body mass index (kg/m2), parity, and mechanical dilation.

Results Among women with oligohydramnios and an unfavorable cervix who underwent induction of labor, 141 (39.4%) received misoprostol and 217 (60.6%) received prostaglandin E2. There were no significant differences in cesarean delivery, chorioamnionitis, postpartum hemorrhage, transfusion, neonatal intensive care unit (NICU) admission, NICU stay > 72 hours, mechanical ventilation, and neonatal sepsis.

Conclusion In women with oligohydramnios and an unfavorable cervix, induction of labor with misoprostol was comparable to prostaglandin E2.

Keywords

cesarean delivery - induction - misoprostol - oligohydramnios - prostaglandin E2

Note

This research was presented, in part, at the Society for Gynecologic Investigation Annual Meeting, 2013 as “Misoprostol for labor induction in pregnancies with oligohydramnios: what's the risk?” Orlando, FL.


 

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