The MisoPROM study: A multicenter randomized comparison of oral misoprostol and oxytocin for premature rupture of membranes at term - 28/08/11
Ann Arbor, Royal Oak, and Grand Rapids, Mich, Dallas, Tex, Albuquerque, NM, Springfield, Mass, Baton Rouge, La, Madison, Wis, and New Britain, Conn
Abstract |
Objective |
This study was undertaken to determine whether induction of labor with oral misoprostol will result in fewer cesarean deliveries than intravenous oxytocin in nulliparous women with premature rupture of membranes at term.
Study design |
Three hundred five women at 10 centers were randomly assigned to receive oral misoprostol, 100 μg every 6 hours to a maximum of two doses or intravenous oxytocin. The primary outcome measure was cesarean deliveries. Secondary outcomes were time from induction to vaginal delivery and measures of maternal and neonatal safety.
Results |
The study was stopped prematurely because of recruitment difficulties. We present the results for the 305 enrolled women. There was no difference in the proportion of women who underwent cesarean delivery (20.1% in the misoprostol group, 19.9% in the oxytocin group). The time interval from induction to vaginal delivery was also similar (11.9 hours for the misoprostol group, and 11.8 hours for the oxytocin group). Maternal and neonatal safety outcomes were similar for the two treatments. More infants born to women in the misoprostol group received intravenous antibiotics in the neonatal period (16.4% vs 6.9%, P=.01), although there were no differences in chorioamnionitis or in proven neonatal infections. Women receiving misoprostol were less likely to have postpartum hemorrhage than those receiving oxytocin (1.9% vs 6.2%, P=.05).
Conclusion |
Oral misoprostol does not offer any advantage in time from induction to vaginal delivery or risk of cesarean section.
Le texte complet de cet article est disponible en PDF.Keywords : Premature rupture of membranes, misoprostol, oxytocin
Plan
 | Supported by the University of Michigan Advisory Council on Clinical Research, the University of Michigan Office of the Vice President for Research, University of Michigan Center for Clinical Investigation and Therapeutics, and St Joseph Mercy Health System. Presented at the Twenty-Third Annual Meeting of the Society for Maternal-Fetal Medicine, San Francisco, Calif, February 3-8, 2003. Reprints not available from the authors. |
Vol 189 - N° 4
P. 1026-1030 - octobre 2003 Retour au numéro
Article précédent
- Fetal transcerebellar diameter nomogram in singleton gestations with special emphasis in the third trimester: A comparison with previously published nomograms
- Martin R Chavez, Cande V Ananth, John C Smulian, Susan Lashley, Eftichia V Kontopoulos, Anthony M Vintzileos
- A prospective randomized controlled trial that compared misoprostol, Foley catheter, and combination misoprostol–Foley catheter for labor induction
- Judith H Chung, Wilson H Huang, Pamela J Rumney, Thomas J Garite, Michael P Nageotte
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