Randomized trial between two active labor management protocols in the presence of an unfavorable cervix
The purpose of this study was to compare the efficacy of two protocols for active management of labor at term in the presence of an unfavorable cervix. Pregnancies that underwent labor induction at ≥37 weeks of gestation with an unfavorable cervix (Bishop score, ≤6) were randomly assigned to receive...
Gespeichert in:
| Veröffentlicht in: | American journal of obstetrics and gynecology 2004, Vol.190 (1), p.124-128 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 128 |
|---|---|
| container_issue | 1 |
| container_start_page | 124 |
| container_title | American journal of obstetrics and gynecology |
| container_volume | 190 |
| creator | Bolnick, Jay M Velazquez, Maria D Gonzalez, Jose L Rappaport, Valerie J McIlwain-Dunivan, Gena Rayburn, William F |
| description | The purpose of this study was to compare the efficacy of two protocols for active management of labor at term in the presence of an unfavorable cervix.
Pregnancies that underwent labor induction at ≥37 weeks of gestation with an unfavorable cervix (Bishop score, ≤6) were randomly assigned to receive vaginally either a single dose of sustained-release dinoprostone (Cervidil) with concurrent low-dose oxytocin or multidosing of misoprostol (25 μg every 4 hours) followed by high-dose oxytocin. The primary outcome was the time interval from induction to vaginal delivery. Other parameters included excess uterine activity and cesarean delivery rates.
A total of 151 patients (dinoprostone, 74 patients; misoprostol, 77 patients) were enrolled. The mean time from the initiation of induction to vaginal delivery was the same in the dinoprostone and misoprostol groups (15.7 hours; 95% CI, 13.7-17.7 hours vs 16.0 hours; 95% CI, 14.1-17.8 hours;
P
=
.34), regardless of parity. The dinoprostone and misoprostol groups did not differ statistically in the percent of patients who were delivered vaginally by 12 hours (36.2% vs 29.7%), 18 hours (63.8% vs 56.3%), and 24 hours (81.0% vs 81.3%). Excess uterine activity was not more common in either group, and hyperstimulation syndrome was absent in all cases. Primary cesarean delivery rates were similar (dinoprostone, 21.6%; misoprostol, 16.9%; relative risk, 1.3; 95% CI, 0.7-2.5), with a failed induction that occurred in one case in each group.
Sustained-release dinoprostone with concurrent low-dose oxytocin and intermittent misoprostol with delayed high-dose oxytocin are effective alternatives for active management of labor with an unfavorable cervix. |
| doi_str_mv | 10.1016/S0002-9378(03)00952-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_80127646</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002937803009529</els_id><sourcerecordid>80127646</sourcerecordid><originalsourceid>FETCH-LOGICAL-c391t-d4dc6026179691d485fdacc6579884d5d852f90067f19731cac10aef1b0437103</originalsourceid><addsrcrecordid>eNqFkEuLFDEURoMoTtv6E5RsFF2U3lSlkspKZPAFA4KPdUglN2OkKhmTdI_6601PN87S1eW7nPvgEPKYwUsGTLz6AgB9pwY5PYfhBYAaW7pDNgyU7MQkprtk8w85Iw9K-XGIvervkzPGJVeCyw25_GyiS2v4g47WHMxCZ6zXiJHW60SNrWGPdDFzynQ10VziirHSq5xqsmkpNDTwO7YGFowWafLURLqL3uxTNvOC1GLeh18PyT1vloKPTnVLvr17-_X8Q3fx6f3H8zcXnR0Uq53jzgroBZNKKOb4NHpnrBWjVNPE3eimsfcKQEjPlByYNZaBQc9m4INkMGzJs-Pe9uLPHZaq11AsLouJmHZFT8B6Kbho4HgEbU6lZPT6KofV5N-agT4Y1jeG9UGfhkHfGG5pS56cDuzmFd3t1ElpA56eAFOsWXw20YZyy4186nsxNu71kcOmYx8w62LDwaELGW3VLoX_vPIXKFmYgg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>80127646</pqid></control><display><type>article</type><title>Randomized trial between two active labor management protocols in the presence of an unfavorable cervix</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Bolnick, Jay M ; Velazquez, Maria D ; Gonzalez, Jose L ; Rappaport, Valerie J ; McIlwain-Dunivan, Gena ; Rayburn, William F</creator><creatorcontrib>Bolnick, Jay M ; Velazquez, Maria D ; Gonzalez, Jose L ; Rappaport, Valerie J ; McIlwain-Dunivan, Gena ; Rayburn, William F</creatorcontrib><description>The purpose of this study was to compare the efficacy of two protocols for active management of labor at term in the presence of an unfavorable cervix.
Pregnancies that underwent labor induction at ≥37 weeks of gestation with an unfavorable cervix (Bishop score, ≤6) were randomly assigned to receive vaginally either a single dose of sustained-release dinoprostone (Cervidil) with concurrent low-dose oxytocin or multidosing of misoprostol (25 μg every 4 hours) followed by high-dose oxytocin. The primary outcome was the time interval from induction to vaginal delivery. Other parameters included excess uterine activity and cesarean delivery rates.
A total of 151 patients (dinoprostone, 74 patients; misoprostol, 77 patients) were enrolled. The mean time from the initiation of induction to vaginal delivery was the same in the dinoprostone and misoprostol groups (15.7 hours; 95% CI, 13.7-17.7 hours vs 16.0 hours; 95% CI, 14.1-17.8 hours;
P
=
.34), regardless of parity. The dinoprostone and misoprostol groups did not differ statistically in the percent of patients who were delivered vaginally by 12 hours (36.2% vs 29.7%), 18 hours (63.8% vs 56.3%), and 24 hours (81.0% vs 81.3%). Excess uterine activity was not more common in either group, and hyperstimulation syndrome was absent in all cases. Primary cesarean delivery rates were similar (dinoprostone, 21.6%; misoprostol, 16.9%; relative risk, 1.3; 95% CI, 0.7-2.5), with a failed induction that occurred in one case in each group.
Sustained-release dinoprostone with concurrent low-dose oxytocin and intermittent misoprostol with delayed high-dose oxytocin are effective alternatives for active management of labor with an unfavorable cervix.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/S0002-9378(03)00952-9</identifier><identifier>PMID: 14749647</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Biological and medical sciences ; Cervical Ripening - drug effects ; Delayed-Action Preparations ; Delivery. Postpartum. Lactation ; Dinoprostone - administration & dosage ; Dinoprostonese ; Drug Administration Schedule ; Drug Therapy, Combination ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Induction of labor ; Labor, Induced - adverse effects ; Labor, Induced - methods ; Medical sciences ; Misoprostol ; Misoprostol - administration & dosage ; Oxytocics - administration & dosage ; Oxytocin ; Oxytocin - therapeutic use ; Pregnancy ; Treatment Failure ; Treatment Outcome</subject><ispartof>American journal of obstetrics and gynecology, 2004, Vol.190 (1), p.124-128</ispartof><rights>2004 Elsevier Inc.</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c391t-d4dc6026179691d485fdacc6579884d5d852f90067f19731cac10aef1b0437103</citedby><cites>FETCH-LOGICAL-c391t-d4dc6026179691d485fdacc6579884d5d852f90067f19731cac10aef1b0437103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002937803009529$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,4010,27900,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15482265$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14749647$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bolnick, Jay M</creatorcontrib><creatorcontrib>Velazquez, Maria D</creatorcontrib><creatorcontrib>Gonzalez, Jose L</creatorcontrib><creatorcontrib>Rappaport, Valerie J</creatorcontrib><creatorcontrib>McIlwain-Dunivan, Gena</creatorcontrib><creatorcontrib>Rayburn, William F</creatorcontrib><title>Randomized trial between two active labor management protocols in the presence of an unfavorable cervix</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>The purpose of this study was to compare the efficacy of two protocols for active management of labor at term in the presence of an unfavorable cervix.
Pregnancies that underwent labor induction at ≥37 weeks of gestation with an unfavorable cervix (Bishop score, ≤6) were randomly assigned to receive vaginally either a single dose of sustained-release dinoprostone (Cervidil) with concurrent low-dose oxytocin or multidosing of misoprostol (25 μg every 4 hours) followed by high-dose oxytocin. The primary outcome was the time interval from induction to vaginal delivery. Other parameters included excess uterine activity and cesarean delivery rates.
A total of 151 patients (dinoprostone, 74 patients; misoprostol, 77 patients) were enrolled. The mean time from the initiation of induction to vaginal delivery was the same in the dinoprostone and misoprostol groups (15.7 hours; 95% CI, 13.7-17.7 hours vs 16.0 hours; 95% CI, 14.1-17.8 hours;
P
=
.34), regardless of parity. The dinoprostone and misoprostol groups did not differ statistically in the percent of patients who were delivered vaginally by 12 hours (36.2% vs 29.7%), 18 hours (63.8% vs 56.3%), and 24 hours (81.0% vs 81.3%). Excess uterine activity was not more common in either group, and hyperstimulation syndrome was absent in all cases. Primary cesarean delivery rates were similar (dinoprostone, 21.6%; misoprostol, 16.9%; relative risk, 1.3; 95% CI, 0.7-2.5), with a failed induction that occurred in one case in each group.
Sustained-release dinoprostone with concurrent low-dose oxytocin and intermittent misoprostol with delayed high-dose oxytocin are effective alternatives for active management of labor with an unfavorable cervix.</description><subject>Biological and medical sciences</subject><subject>Cervical Ripening - drug effects</subject><subject>Delayed-Action Preparations</subject><subject>Delivery. Postpartum. Lactation</subject><subject>Dinoprostone - administration & dosage</subject><subject>Dinoprostonese</subject><subject>Drug Administration Schedule</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Induction of labor</subject><subject>Labor, Induced - adverse effects</subject><subject>Labor, Induced - methods</subject><subject>Medical sciences</subject><subject>Misoprostol</subject><subject>Misoprostol - administration & dosage</subject><subject>Oxytocics - administration & dosage</subject><subject>Oxytocin</subject><subject>Oxytocin - therapeutic use</subject><subject>Pregnancy</subject><subject>Treatment Failure</subject><subject>Treatment Outcome</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEuLFDEURoMoTtv6E5RsFF2U3lSlkspKZPAFA4KPdUglN2OkKhmTdI_6601PN87S1eW7nPvgEPKYwUsGTLz6AgB9pwY5PYfhBYAaW7pDNgyU7MQkprtk8w85Iw9K-XGIvervkzPGJVeCyw25_GyiS2v4g47WHMxCZ6zXiJHW60SNrWGPdDFzynQ10VziirHSq5xqsmkpNDTwO7YGFowWafLURLqL3uxTNvOC1GLeh18PyT1vloKPTnVLvr17-_X8Q3fx6f3H8zcXnR0Uq53jzgroBZNKKOb4NHpnrBWjVNPE3eimsfcKQEjPlByYNZaBQc9m4INkMGzJs-Pe9uLPHZaq11AsLouJmHZFT8B6Kbho4HgEbU6lZPT6KofV5N-agT4Y1jeG9UGfhkHfGG5pS56cDuzmFd3t1ElpA56eAFOsWXw20YZyy4186nsxNu71kcOmYx8w62LDwaELGW3VLoX_vPIXKFmYgg</recordid><startdate>2004</startdate><enddate>2004</enddate><creator>Bolnick, Jay M</creator><creator>Velazquez, Maria D</creator><creator>Gonzalez, Jose L</creator><creator>Rappaport, Valerie J</creator><creator>McIlwain-Dunivan, Gena</creator><creator>Rayburn, William F</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2004</creationdate><title>Randomized trial between two active labor management protocols in the presence of an unfavorable cervix</title><author>Bolnick, Jay M ; Velazquez, Maria D ; Gonzalez, Jose L ; Rappaport, Valerie J ; McIlwain-Dunivan, Gena ; Rayburn, William F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c391t-d4dc6026179691d485fdacc6579884d5d852f90067f19731cac10aef1b0437103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Biological and medical sciences</topic><topic>Cervical Ripening - drug effects</topic><topic>Delayed-Action Preparations</topic><topic>Delivery. Postpartum. Lactation</topic><topic>Dinoprostone - administration & dosage</topic><topic>Dinoprostonese</topic><topic>Drug Administration Schedule</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Induction of labor</topic><topic>Labor, Induced - adverse effects</topic><topic>Labor, Induced - methods</topic><topic>Medical sciences</topic><topic>Misoprostol</topic><topic>Misoprostol - administration & dosage</topic><topic>Oxytocics - administration & dosage</topic><topic>Oxytocin</topic><topic>Oxytocin - therapeutic use</topic><topic>Pregnancy</topic><topic>Treatment Failure</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bolnick, Jay M</creatorcontrib><creatorcontrib>Velazquez, Maria D</creatorcontrib><creatorcontrib>Gonzalez, Jose L</creatorcontrib><creatorcontrib>Rappaport, Valerie J</creatorcontrib><creatorcontrib>McIlwain-Dunivan, Gena</creatorcontrib><creatorcontrib>Rayburn, William F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bolnick, Jay M</au><au>Velazquez, Maria D</au><au>Gonzalez, Jose L</au><au>Rappaport, Valerie J</au><au>McIlwain-Dunivan, Gena</au><au>Rayburn, William F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized trial between two active labor management protocols in the presence of an unfavorable cervix</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2004</date><risdate>2004</risdate><volume>190</volume><issue>1</issue><spage>124</spage><epage>128</epage><pages>124-128</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>The purpose of this study was to compare the efficacy of two protocols for active management of labor at term in the presence of an unfavorable cervix.
Pregnancies that underwent labor induction at ≥37 weeks of gestation with an unfavorable cervix (Bishop score, ≤6) were randomly assigned to receive vaginally either a single dose of sustained-release dinoprostone (Cervidil) with concurrent low-dose oxytocin or multidosing of misoprostol (25 μg every 4 hours) followed by high-dose oxytocin. The primary outcome was the time interval from induction to vaginal delivery. Other parameters included excess uterine activity and cesarean delivery rates.
A total of 151 patients (dinoprostone, 74 patients; misoprostol, 77 patients) were enrolled. The mean time from the initiation of induction to vaginal delivery was the same in the dinoprostone and misoprostol groups (15.7 hours; 95% CI, 13.7-17.7 hours vs 16.0 hours; 95% CI, 14.1-17.8 hours;
P
=
.34), regardless of parity. The dinoprostone and misoprostol groups did not differ statistically in the percent of patients who were delivered vaginally by 12 hours (36.2% vs 29.7%), 18 hours (63.8% vs 56.3%), and 24 hours (81.0% vs 81.3%). Excess uterine activity was not more common in either group, and hyperstimulation syndrome was absent in all cases. Primary cesarean delivery rates were similar (dinoprostone, 21.6%; misoprostol, 16.9%; relative risk, 1.3; 95% CI, 0.7-2.5), with a failed induction that occurred in one case in each group.
Sustained-release dinoprostone with concurrent low-dose oxytocin and intermittent misoprostol with delayed high-dose oxytocin are effective alternatives for active management of labor with an unfavorable cervix.</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>14749647</pmid><doi>10.1016/S0002-9378(03)00952-9</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9378 |
| ispartof | American journal of obstetrics and gynecology, 2004, Vol.190 (1), p.124-128 |
| issn | 0002-9378 1097-6868 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_80127646 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Biological and medical sciences Cervical Ripening - drug effects Delayed-Action Preparations Delivery. Postpartum. Lactation Dinoprostone - administration & dosage Dinoprostonese Drug Administration Schedule Drug Therapy, Combination Female Gynecology. Andrology. Obstetrics Humans Induction of labor Labor, Induced - adverse effects Labor, Induced - methods Medical sciences Misoprostol Misoprostol - administration & dosage Oxytocics - administration & dosage Oxytocin Oxytocin - therapeutic use Pregnancy Treatment Failure Treatment Outcome |
| title | Randomized trial between two active labor management protocols in the presence of an unfavorable cervix |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T17%3A34%3A33IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Randomized%20trial%20between%20two%20active%20labor%20management%20protocols%20in%20the%20presence%20of%20an%20unfavorable%20cervix&rft.jtitle=American%20journal%20of%20obstetrics%20and%20gynecology&rft.au=Bolnick,%20Jay%20M&rft.date=2004&rft.volume=190&rft.issue=1&rft.spage=124&rft.epage=128&rft.pages=124-128&rft.issn=0002-9378&rft.eissn=1097-6868&rft.coden=AJOGAH&rft_id=info:doi/10.1016/S0002-9378(03)00952-9&rft_dat=%3Cproquest_cross%3E80127646%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=80127646&rft_id=info:pmid/14749647&rft_els_id=S0002937803009529&rfr_iscdi=true |