Misoprostol versus dinoprostone for labor induction

Results from a recent comparison of misoprostol and dinoprostone show similar results with the drugs when given vaginally for labor induction. The authors noted, however, that lower modified Bishop scores, higher body mass index (BMI) and a higher rate of fetal scalp blood testing was seen in the group that received misoprostol.

Published in the European Journal of Obstetrics & Gynecology and Reproductive Biology, the findings are from a retrospective cohort study by Austrian researchers. They compared 119 labor inductions with 200 µg misoprostol with 124 inductions with 10 mg of dinoprostone; the former occurred between June and October 2014 and the latter occurred between December 2013 and April 2014.

The authors looked at reduction in time to vaginal delivery and delivery within 24 hours and time from insert application to vaginal delivery in routine clinical practice and evaluated modified Bishop scores, BMI, and need for fetal scalp blood testing. Vaginal delivery within 24 hours of insert placement occurred in 77.3% of the women in the misoprostol versus 74.2% of those who received dinoprostone (P=0.654). Times from application to vaginal delivery also were similar in the cohorts (761.76 minutes for misoprostol versus 805.17 minutes in the dinoprostone group [P=0.817). Cesarean delivery was performed in 10.1% of those who received misoprostol versus 10.5% of those who received dinoprostone. Rates of transfer to the neonatal unit or any type of fetal acidosis also did not differ between the groups.

The researchers reported modified Bishop scores of 2.0 versus 3.0 (P=0.001) in the misoprostol and dinoprostone groups, respectively. Mean BMI also differed between the two groups (24.72 for misoprostol versus 23.95 for dinoprostone; P=0.033) and fetal scalp blood resting was required in 12.6% of the misoprostol group versus 3.2% of the dinoprostone group (P=0.008).