Journal article
The risk of placental abruption when using prostaglandins for cervical ripening in women with preeclampsia: comparing misoprostol versus dinoprostone.
- Martinez de Tejada B University Hospitals of Geneva and Faculty of Medicine, Obstetrics and Gynecology, Geneva, 1211 Switzerland. begona.mdt@bluewin.ch
- Martillotti G
- Lapaire O
- Hoesli I
- Irion O
- 2009-11-28
Published in:
- The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. - 2010
Abruptio Placentae
Administration, Intravaginal
Adolescent
Adult
Cervical Ripening
Dinoprostone
Female
Humans
Incidence
Labor, Induced
Middle Aged
Misoprostol
Oxytocics
Pre-Eclampsia
Pregnancy
Prostaglandins
Risk
Young Adult
English
OBJECTIVE
Recent data have raised concern about the safety of using misoprostol in women with preeclampsia. We wanted to evaluate the risk of placental abruption in women with preeclampsia undergoing cervical ripening with misoprostol compared to dinoprostone.
METHODS
We evaluated data on 403 preeclamptic women receiving either misoprostol (N = 235) or dinoprostone (N = 168) at different regimens and delivering in two university hospitals in Switzerland (Geneva and Basel). The main outcome was the incidence of placental abruption in both groups using two definitions for placental abruption ("clinical" and "post hoc"). We performed univariable and multivariable analysis.
RESULTS
The overall incidence of placental abruption was 1.5% (six cases); 1.3% (3) in the misoprostol group versus 1.8% (3) in the dinoprostone group; p = 0.69). When using the post-hoc definition the incidence was higher in the latter group (1.3 versus 5.4%; p = 0.03). In multivariable analyses, the risk of placental abruption using the "post hoc" definition was associated with the use of dinoprostone.
CONCLUSIONS
The use of misoprotol in preeclamptic women appears to be safe and is not associated with a higher risk of placental abruption when compared with other prostaglandins. Concerns about the use of misoprostol in the case of preeclampsia are not justified.
Recent data have raised concern about the safety of using misoprostol in women with preeclampsia. We wanted to evaluate the risk of placental abruption in women with preeclampsia undergoing cervical ripening with misoprostol compared to dinoprostone.
METHODS
We evaluated data on 403 preeclamptic women receiving either misoprostol (N = 235) or dinoprostone (N = 168) at different regimens and delivering in two university hospitals in Switzerland (Geneva and Basel). The main outcome was the incidence of placental abruption in both groups using two definitions for placental abruption ("clinical" and "post hoc"). We performed univariable and multivariable analysis.
RESULTS
The overall incidence of placental abruption was 1.5% (six cases); 1.3% (3) in the misoprostol group versus 1.8% (3) in the dinoprostone group; p = 0.69). When using the post-hoc definition the incidence was higher in the latter group (1.3 versus 5.4%; p = 0.03). In multivariable analyses, the risk of placental abruption using the "post hoc" definition was associated with the use of dinoprostone.
CONCLUSIONS
The use of misoprotol in preeclamptic women appears to be safe and is not associated with a higher risk of placental abruption when compared with other prostaglandins. Concerns about the use of misoprostol in the case of preeclampsia are not justified.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.3109/14767050903443475
- PMID 19941444
- Persistent URL
- https://roar.hep-bejune.ch/global/documents/38666
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