Display options
Cite
Patte C, Deruelle P. A critical appraisal of the misoprostol removable, controlled-release vaginal delivery system of labor induction. Int J Womens Health. 2015;7:889-99doi: 10.2147/IJWH.S62372.
Patte, C., & Deruelle, P. (2015). A critical appraisal of the misoprostol removable, controlled-release vaginal delivery system of labor induction. International journal of women's health, 7889-99. https://doi.org/10.2147/IJWH.S62372
Patte, Charlotte, and Deruelle, Philippe. "A critical appraisal of the misoprostol removable, controlled-release vaginal delivery system of labor induction." International journal of women's health vol. 7 (2015): 889-99. doi: https://doi.org/10.2147/IJWH.S62372
Patte C, Deruelle P. A critical appraisal of the misoprostol removable, controlled-release vaginal delivery system of labor induction. Int J Womens Health. 2015 Nov 12;7:889-99. doi: 10.2147/IJWH.S62372. eCollection 2015. PMID: 26648758; PMCID: PMC4648618.
Copy Download .nbib Format: NLM
Share it on

Int J Womens Health. 2015 Nov 12;7:889-99. doi: 10.2147/IJWH.S62372. eCollection 2015.

A critical appraisal of the misoprostol removable, controlled-release vaginal delivery system of labor induction.

International journal of women's health

Charlotte Patte, Philippe Deruelle

Affiliations

  1. Lille University Hospital, Jeanne De Flandre Maternity, Université Lille 2, Lille, France.
  2. Lille University Hospital, Jeanne De Flandre Maternity, Université Lille 2, Lille, France ; UPRES EA 4489, Environnement périnatal et santé, Faculté de médecine Henri Warembourg, Université Lille 2, Lille, France.

PMID: 26648758 PMCID: PMC4648618 DOI: 10.2147/IJWH.S62372

Abstract

BACKGROUND: Induction of labor is a major issue in pregnancy management. Finding strategies to increase rate and decrease time to vaginal delivery is an important goal, but maternal or neonatal safety must remain the primary objective. Misoprostol is a synthetic analogue of prostaglandin used off label to ripen the cervix and induce labor. The misoprostol vaginal insert (MVI) was designed to allow a controlled-release delivery of misoprostol (from 50 to 200 μg) with a removal tape. The objective of this review was to make a critical appraisal of this device referring to the literature.

METHODS: A literature search was performed in the PubMed and Cochrane databases using the keywords "vaginal misoprostol insert".

RESULTS: Several studies compared different doses of MVI (50, 100, 150, and 200 μg) with the 10 mg dinoprostone insert. The 100 μg MVI compared with the dinoprostone vaginal insert (DVI) showed similar efficacy and no significant differences in cesarean delivery rate. MVI 200 μg compared with DVI showed a reduced time to vaginal delivery and oxytocin need but had an increased risk of uterine hyperstimulation. The rate of hyperstimulation syndrome was two to three times more frequent with the 200 μg MVI than the 100 μg.

CONCLUSION: Current data suggest that the 100 μg MVI would provide the best balance between efficacy and safety. Further studies should be performed to evaluate this dose, especially in high-risk situations needing induction of labor.

Keywords: efficacy; pregnancy; prostaglandins; safety

References

  1. Obstet Gynecol. 1997 Nov;90(5):735-8 - PubMed
  2. Obstet Gynecol. 1998 May;91(5 Pt 2):828-30 - PubMed
  3. Cochrane Database Syst Rev. 2010 Oct 06;(10):CD000941 - PubMed
  4. J Gynecol Obstet Biol Reprod (Paris). 2012 Apr;41(2):151-66 - PubMed
  5. Obstet Gynecol. 1997 Jul;90(1):88-92 - PubMed
  6. Hum Reprod. 2002 Feb;17(2):332-6 - PubMed
  7. Eur J Obstet Gynecol Reprod Biol. 2004 Mar 15;113(1):45-8 - PubMed
  8. Am J Obstet Gynecol. 2005 Sep;193(3 Pt 2):1071-5 - PubMed
  9. Obstet Gynecol. 2009 Aug;114(2 Pt 1):261-7 - PubMed
  10. Int J Gynaecol Obstet. 2000 Jan;68(1):43-4 - PubMed
  11. J Matern Fetal Neonatal Med. 2013 Jan;26(2):127-31 - PubMed
  12. Obstet Gynecol. 1998 Mar;91(3):401-5 - PubMed
  13. Birth. 1999 Dec;26(4):211-4 - PubMed
  14. Obstet Gynecol. 2011 Mar;117(3):533-41 - PubMed
  15. Am J Obstet Gynecol. 1999 Jun;180(6 Pt 1):1535-42 - PubMed
  16. J Clin Pharmacol. 2008 Jan;48(1):26-34 - PubMed
  17. Rev Paul Med. 1987 Nov-Dec;105(6):325-8 - PubMed
  18. Eur J Obstet Gynecol Reprod Biol. 2011 Jun;156(2):144-8 - PubMed
  19. Obstet Gynecol. 1997 May;89(5 Pt 2):832-3 - PubMed
  20. J Reprod Med. 2008 Sep;53(9):695-6 - PubMed
  21. Aust N Z J Obstet Gynaecol. 2002 Oct;42(4):412 - PubMed
  22. Obstet Gynecol. 1997 Dec;90(6):911-5 - PubMed
  23. Clin Obstet Gynecol. 2006 Sep;49(3):564-72 - PubMed
  24. Obstet Gynecol. 1998 May;91(5 Pt 1):774-9 - PubMed
  25. Obstet Gynecol. 2008 Oct;112(4):801-12 - PubMed
  26. Am J Obstet Gynecol. 1999 Jun;180(6 Pt 1):1551-9 - PubMed
  27. J Matern Fetal Neonatal Med. 2016;29(4):517-22 - PubMed
  28. Obstet Gynecol. 2013 Aug;122(2 Pt 1):193-4 - PubMed
  29. N Engl J Med. 1995 Apr 13;332(15):983-7 - PubMed
  30. Am J Obstet Gynecol. 1995 Oct;173(4):1137-42 - PubMed
  31. Aust N Z J Obstet Gynaecol. 1998 Feb;38(1):96-7 - PubMed
  32. Obstet Gynecol. 2009 Dec;114(6):1315-21 - PubMed
  33. Am J Obstet Gynecol. 1998 Jun;178(6):1333-40 - PubMed
  34. Acta Obstet Gynecol Scand. 1997 Oct;76(9):856-61 - PubMed
  35. J Soc Gynecol Investig. 2006 Feb;13(2):112-7 - PubMed
  36. Eur J Obstet Gynecol Reprod Biol. 2005 Nov 1;123(1):56-61 - PubMed
  37. Obstet Gynecol. 2006 Nov;108(5):1130-7 - PubMed
  38. Obstet Gynecol. 1964 Aug;24:266-8 - PubMed
  39. Obstet Gynecol. 2013 Aug;122(2 Pt 1):201-9 - PubMed
  40. Int J Gynaecol Obstet. 2007 Dec;99 Suppl 2:S160-7 - PubMed

Publication Types