Analysis of Variables that Influence the Success Rates of Induction of Labor with Misoprostol: A Retrospective Observational Study

Abstract Objective  Determine the predictive criteria for success in inducing labor for live fetuses using misoprostol in pregnant women. Secondarily, the objective is to determine the rates of vaginal or cesarean delivery, duration of induction, interval of administration of misoprostol, the main c...

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Bibliographic Details
Published in:Revista Brasileira de ginecologia e obstetrícia 2022-04, Vol.44 (4), p.327-335
Main Authors: Corrêa, Thayane Delazari, Barreto Junior, Adriano Nascimento, Batista, Maria Clara Mendes, Corrêa Júnior, Mário Dias, Leite, Henrique Vitor
Format: Article
Language:eng ; por
Subjects:
Administration, Intravaginal
Adult
Female
Humans
Labor, Induced
Misoprostol
OBSTETRICS & GYNECOLOGY
Original
Original Article
Oxytocics - therapeutic use
Pregnancy
Retrospective Studies
Young Adult
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Summary:Abstract Objective  Determine the predictive criteria for success in inducing labor for live fetuses using misoprostol in pregnant women. Secondarily, the objective is to determine the rates of vaginal or cesarean delivery, duration of induction, interval of administration of misoprostol, the main causes of induction of labor and indication for operative delivery. Methods  Medical records of 873 pregnant women admitted for cervical maturation from January 2017 to December 2018 were reviewed in a descriptive observational study of retrospective analysis, considering the following response variables: age, parity, Bishop Index, doses of misoprostol, labor induction time. Logistic regression models were used to predict success with misoprostol in non-operative deliveries. Results  Of the 873 patients evaluated, 72% evolved with vaginal delivery, 23% of the cases were cesarean, 5% forceps or vacuum-extractor. For non-operative delivery the predictive variables at admission were age, parity, gestational age and dilation. During hospitalization, fewer vaginal touches, amniotomy or amniorrhexis with clear fluid lead to a shorter induction time and a greater chance of non-operative delivery. False positives and false negatives of the model were always below 50% and correct answers above 65%. Conclusion  At admission, age less than 24 years, previous normal births, lower the gestational age and greater the dilation, were predictive of greater probability of non-operative delivery. During hospitalization, the less vaginal touches and occurrence of amniotomy/amniorrhexis with clear liquid indicate shorter induction time. Future studies with a prospective design and analysis of other factors are necessary to assess the replicability, generalization of these findings.
ISSN:0100-7203
1806-9339
1806-9339
DOI:10.1055/s-0042-1744287