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Labor induction with the prostaglandin E1 methyl analog misoprostol versus oxytocin: A randomized trial
Int J Gynecol Obstet, 1993, 43: 229-236
229
International Federation of Gynecology and Obstetrics
Citations from the Literature
This is a selection of abstracts taken from the literature in the field of obstetrics and gynecology which the Journal’s Editors feel may be of interest to our readers*
PERINATOLOGY
Effects of fish oil supplementation in the third trimester of pregnancy on ptostacyclin
Labor induction with the ptostnglandin E, methyl misoprostol versus oxytocin: A randomized trial
analog
Sanchez-Ramos L.; Kaunitz A.M.; Del Valle GO.; Delke I.; Schroeder P.A.; Briones D.K. USA
OBSTET GYNECOL 1993 81/3 (332-336) Objective: To compare the safety and efficacy of intravaginal misoprostol versus intravenous (IV) oxytocin infusion for labor induction. Methods: One hundred thirty patients were randomly assigned to one of two induction groups: (I) intravaginal misoprostol or (2) IV oxytocin by continuous infusion, with prior cervical ripening using prostaglandin (PG) E, gel if necessary. Results: Among 129 patients evaluated, 64 were allocated to the misoprostol group and 65 to the oxytocin group. Prostaglandin E, gel was administered to 29 patients (45%) in the oxytocin group with unripe cervices. Uterine tachysystole occurred more frequently in patients in the misoprostol group (34.4%) than in the oxytocin group (13.8%) (P < 0.05). Nevertheless, no statistically significant differences were noted between the groups in intrapartum complications including uterine hyperstimulation syndrome, mode of delivery, and neonatal or maternal adverse outcomes. The interval from induction to vaginal delivery was significantly shorter in the misoprostol group (I I versus I8 h; P = 0.004). In 74% of patients in the misoprostol group, only one intravaginal dose was required for successful labor induction. Conclusions: Intravaginal administration of misoprostol safely and effectively induces labor while minimizing the expense associated with IV oxytocin infusion. The higher frequency of uterine tachysystole associated with the use of misoprostol did not increase the risk of adverse intrapartum or perinatal outcomes. The use of PGE, gel for cervical ripening contributed to the longer induction-to-vaginal delivery interval noted in the oxytocin group. Clinical trials appear warranted to detail misoprostol’s optimal route, dose, and schedule for labor induction and its safety.
nod thromboxaw
production
Sorensen J.D.; Olsen S.F.; Pedersen A.K.; Boris J.; Secher N.J.; FitzGerald G.A. DNK
AM J OBSTET GYNECOL 1993 l68/3 I (915-922) Objective: Disturbance in thromboxane and prostacyclin biosynthesis has been observed in preeclampsia. We studied whether fish oil supplementation in late pregnancy interferes with maternal and fetal production of thromboxane A, and prostacyclin I,. Study design: Forty-seven women in the thirtieth week of pregnancy were randomly assigned in a ratio of 2:l:l to receive fish oil (2.7 gm of n-3 fatty acid per day [Pikasol]), or either olive oil or no oil supplementation as controls. Metabolites of thromboxane A2 and A, and of prostacyclin I, and I, were quantified by mass spectrometry methods in serum and urine, respectively. Maternal serum and urine were sampled at baseline, in the thirty-third and thirtyseventh weeks of pregnancy. Fetal serum was sampled at delivery. Results: At the thirty-seventh week the mean concentrametabolites, eicosapentaenoic-derived tions of the thromboxane B, and prostacyclin I,, was twofold to threefold higher (P < 0.001) in the group receiving fish oil compared with combined control groups. There were no significant effects of fish oil on the prostacyclin I, metabolite, although there was a trend toward a reduction in thromboxane B, in this group. In umbilical cord blood the mean concentration of thromboxane Bz was lowest in the group receiving fish oil (p = 0.03). Conclusions: Fish oil was metabolized to the eicosapentaenoic acid-derived eicosanoids thromboxane A, and prostacyclin 13 in pregnant women. Correspondingly, analog products of arachidonic acid tended to be depressed. If remains to be established whether these biochemical effects will prove beneficial in the prevention or treatment of preeclampsia and intrauterine growth retardation.
Production of prostacyclin and thromboxane cies: Effect of small dose of aspirin
in lupus pregnan-
Kaaja R.; Julkunen H.; Viinikka L.; Ylikorkala 0. *Generated from the Excerpta Medica Database, EMBASE.
FIN Int J Gynecol Obstet 43
229
International Federation of Gynecology and Obstetrics
Citations from the Literature
This is a selection of abstracts taken from the literature in the field of obstetrics and gynecology which the Journal’s Editors feel may be of interest to our readers*
PERINATOLOGY
Effects of fish oil supplementation in the third trimester of pregnancy on ptostacyclin
Labor induction with the ptostnglandin E, methyl misoprostol versus oxytocin: A randomized trial
analog
Sanchez-Ramos L.; Kaunitz A.M.; Del Valle GO.; Delke I.; Schroeder P.A.; Briones D.K. USA
OBSTET GYNECOL 1993 81/3 (332-336) Objective: To compare the safety and efficacy of intravaginal misoprostol versus intravenous (IV) oxytocin infusion for labor induction. Methods: One hundred thirty patients were randomly assigned to one of two induction groups: (I) intravaginal misoprostol or (2) IV oxytocin by continuous infusion, with prior cervical ripening using prostaglandin (PG) E, gel if necessary. Results: Among 129 patients evaluated, 64 were allocated to the misoprostol group and 65 to the oxytocin group. Prostaglandin E, gel was administered to 29 patients (45%) in the oxytocin group with unripe cervices. Uterine tachysystole occurred more frequently in patients in the misoprostol group (34.4%) than in the oxytocin group (13.8%) (P < 0.05). Nevertheless, no statistically significant differences were noted between the groups in intrapartum complications including uterine hyperstimulation syndrome, mode of delivery, and neonatal or maternal adverse outcomes. The interval from induction to vaginal delivery was significantly shorter in the misoprostol group (I I versus I8 h; P = 0.004). In 74% of patients in the misoprostol group, only one intravaginal dose was required for successful labor induction. Conclusions: Intravaginal administration of misoprostol safely and effectively induces labor while minimizing the expense associated with IV oxytocin infusion. The higher frequency of uterine tachysystole associated with the use of misoprostol did not increase the risk of adverse intrapartum or perinatal outcomes. The use of PGE, gel for cervical ripening contributed to the longer induction-to-vaginal delivery interval noted in the oxytocin group. Clinical trials appear warranted to detail misoprostol’s optimal route, dose, and schedule for labor induction and its safety.
nod thromboxaw
production
Sorensen J.D.; Olsen S.F.; Pedersen A.K.; Boris J.; Secher N.J.; FitzGerald G.A. DNK
AM J OBSTET GYNECOL 1993 l68/3 I (915-922) Objective: Disturbance in thromboxane and prostacyclin biosynthesis has been observed in preeclampsia. We studied whether fish oil supplementation in late pregnancy interferes with maternal and fetal production of thromboxane A, and prostacyclin I,. Study design: Forty-seven women in the thirtieth week of pregnancy were randomly assigned in a ratio of 2:l:l to receive fish oil (2.7 gm of n-3 fatty acid per day [Pikasol]), or either olive oil or no oil supplementation as controls. Metabolites of thromboxane A2 and A, and of prostacyclin I, and I, were quantified by mass spectrometry methods in serum and urine, respectively. Maternal serum and urine were sampled at baseline, in the thirty-third and thirtyseventh weeks of pregnancy. Fetal serum was sampled at delivery. Results: At the thirty-seventh week the mean concentrametabolites, eicosapentaenoic-derived tions of the thromboxane B, and prostacyclin I,, was twofold to threefold higher (P < 0.001) in the group receiving fish oil compared with combined control groups. There were no significant effects of fish oil on the prostacyclin I, metabolite, although there was a trend toward a reduction in thromboxane B, in this group. In umbilical cord blood the mean concentration of thromboxane Bz was lowest in the group receiving fish oil (p = 0.03). Conclusions: Fish oil was metabolized to the eicosapentaenoic acid-derived eicosanoids thromboxane A, and prostacyclin 13 in pregnant women. Correspondingly, analog products of arachidonic acid tended to be depressed. If remains to be established whether these biochemical effects will prove beneficial in the prevention or treatment of preeclampsia and intrauterine growth retardation.
Production of prostacyclin and thromboxane cies: Effect of small dose of aspirin
in lupus pregnan-
Kaaja R.; Julkunen H.; Viinikka L.; Ylikorkala 0. *Generated from the Excerpta Medica Database, EMBASE.
FIN Int J Gynecol Obstet 43