misoprostol and Oligohydramnios

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Therapeutic; Adult; Breech Presentation; Female; Fetal Death; Humans; Hydrocephalus; Misoprostol; Oligohydramnios; Pregnancy; Pregnancy Trimester, Third; Treatment Outcome; Ultrasonography, Prenatal

The efficacy and safety of misoprostol for cervical ripening and labor induction in patients with oligohydramnios was investigated. 57 pregnancies with oligohydramnios and 58 cases with a normal amniotic fluid volume (controls) were enrolled in this prospective trial. All patients received 50 microg of intravaginal misoprostol every 5 h. Primary outcomes were: cesarean section rate; induction to delivery time; oxytocin augmentation; uterine hyperstimulation; meconium passage; fetal heart rate (FHR) changes; fetal distress requiring delivery, and Apgar scores. There were no differences in the mean time to delivery, cesarean section rate, oxytocin augmentation or Apgar scores. The mean induction to delivery time in oligohydramnios and control groups were, 11 h 43 min and 11 h 18 min, respectively (p > 0.05). FHR changes were observed in 26.3% of oligohydramnios group and 32.7% of control group (p > 0.05). There was no statistically significant difference in the cesarean section rate and the uterine hyperstimulation between the 2 groups. These data suggest that misoprostol can be used as an effective agent for cervical ripening and labor induction in pregnancies with oligohydramnios without increasing the risk for perinatal outcome, compared to those with normal amniotic fluid volumes.

Topics: Administration, Intravaginal; Adult; Apgar Score; Cervical Ripening; Cesarean Section; Female; Fetal Distress; Gestational Age; Heart Rate, Fetal; Humans; Labor, Induced; Misoprostol; Oligohydramnios; Oxytocics; Oxytocin; Pregnancy; Prospective Studies; Risk Factors; Time Factors

Oral mifepristone combined with rivanol lactate (rivanol) is commonly used in second-trimester pregnancy termination. However, rivanol is not suitable to premature rupture of membranes and oligohydramnios because amniocentesis is difficult. Mifepristone combined with misoprostol is suitable for the patients with oligohydramnios. In accordance with the misoprostol dosing recommendations by the International Federation of Gynecology and Obstetrics (FIGO), the incidences of uterine rupture and cervical laceration are relatively high in Chinese pregnant women. The aim of our study was to optimize misoprostol dosing regimen in terms of efficacy and safety in Chinese pregnant women.We modified the Bishop Score, and then gave patients low-dose misoprostol according to the modified Bishop score. Based on the amniotic fluid volume (AFV) indicated by type-B ultrasonic instrument, the cases with AFV ≤2 cm receiving low-dose misoprostol combined with mifepristone and the cases with amniocentesis failure followed by receiving low-dose misoprostol combined with mifepristone were enrolled into study group, and the cases with AFV >2 cm receiving rivanol combined with mifepristone were enrolled into control group. The start time of uterine contractions, time of fetal expulsion, birth process, hospital day, successful induced labor rate, complete induced labor rate, and incomplete induced labor rate were observed and compared between the 2 groups.There were significant differences in the start time of uterine contractions, time of fetal expulsion, birth process, and hospital day between the control group and the study group (all P < .05). The successful induced labor rate, complete induced labor rate, and incomplete induced labor rate were also significantly different between the 2 groups (all P < .05).In the induced labor of 16 to 28 weeks pathological pregnancy, low-dose misoprostol can markedly improve the successful induced labor rate and complete induced labor rate, shorten the birth process and hospital day, and decrease uterine curettage rate and uterine rupture risk. Low-dose misoprostol combined with mifepristone is suitable to the induced labor of 16 to 28 weeks pathological pregnancy in Chinese women.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Induced; Adult; Asian People; China; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Humans; Mifepristone; Misoprostol; Oligohydramnios; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Second; Time Factors; Uterine Rupture

The aim of the study was to determine whether anhydramnios affected the duration of medical abortion in cases with various indications as compared to cases with normal amniotic fluid volume.. Patients who were admitted to our clinic because of medical abortion between January 2010-December 2013 were included in this retrospective study. A total of 32 pregnant women with anhydramnios (study group) and 67 pregnant women with normal amniotic fluid volume but with fetal abnormality (control group) were included in the study. Patient age, gravidity, parity, gestational age, previous delivery route, and duration of the abortion were recorded.. Mean duration of the abortion in the study group was 71.93 ± 47.51 h as compared to 79.08 ± 52.62 h in the control group. There were no statistically significant differences between the two groups in terms of duration of the abortion (p = 0.516). Also, we found no statistically significant differences in duration of the abortion with regard to previous delivery route (p = 0.220).. There were no statistically significant differences between the study group and controls in terms of duration of the abortion. In addition, neither parity nor previous delivery route affected the duration of the abortion.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Induced; Adolescent; Adult; Delivery, Obstetric; Female; Humans; Misoprostol; Oligohydramnios; Parity; Pregnancy; Retrospective Studies; Time Factors; Young Adult

Topics: Adult; Cervix Uteri; Female; Humans; Infant, Newborn; Labor, Induced; Misoprostol; Oligohydramnios; Oxytocics; Pregnancy; Uterine Rupture