Comparison of dinoprostone, misoprostol and amniotomy in labor induction

Abstract

Objective: Comparison of dinoprostone, misoprostol and amniotomy in labor induction. Methods: The study group included a total of 437 women who underwent consecutive induction of labor after evaluation of the indication and Bishop’s score. The most common indications were: postmaturity, hypertensive disease, diabetes mellitus and fetal growth restriction. In 327 cases we chose to induce labor using vaginal tablets of dinoprostone at a dose of 0.75 mg, in 36 cases dinoprostone at a dose of 3 mg, in 16 cases we used a vaginal insert of misoprostol (200 μg), and in 58 cases amniotomy was performed. Results: In the subgroup of dinoprostone (0.75 mg) the rate of vaginal delivery (including extraction delivery) was 90.2%, in the subgroup of dinoprostone (3 mg) it was 91.6%, in the subgroup of misoprostol it was 100% and in the subgroup of amniotomy it was 93.1%. The time period between onset of labor induction and delivery was an average of 15.75 hours in the dinoprostone (0.75 mg) subgroup, 21.41 hours in the dinoprostone (3 mg) subgroup, 17.41 hours in the misoprostol subgroup and 7.49 hours in the amniotomy subgroup. Conclusion: Subgroup of patients with misoprostol showed the highest rate of vaginal delivery after labor induction. In the subgroup with amniotomy, the shortest time period between onset of induction and delivery was reached. Key words: Bishop score – induction of labor – predictive factors – nulliparity