Misoprostol Vaginal Insert and Time to Vaginal Delivery: A Randomized Controlled Trial

@article{Wing2013MisoprostolVI,
  title={Misoprostol Vaginal Insert and Time to Vaginal Delivery: A Randomized Controlled Trial},
  author={Deborah A. Wing and Raymond Brown and Lauren A. Plante and Hugh S. Miller and Olof Rugarn and Barbara L. Powers},
  journal={Obstetrics \& Gynecology},
  year={2013},
  volume={122},
  pages={201–209}
}
OBJECTIVE: To compare the efficacy and safety of a 200-microgram misoprostol vaginal insert with a 10-mg dinoprostone vaginal insert for reducing the time to vaginal delivery. METHODS: In a phase III, double-blind, multicenter study, women being induced with a modified Bishop score of 4 or less were randomly assigned to receive either a 200-microgram misoprostol vaginal insert or a 10-mg dinoprostone vaginal insert. Coprimary end points were time to vaginal delivery and rate of cesarean… 
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Misoprostol vaginal insert versus misoprostol vaginal tablets for the induction of labour: a cohort study
TLDR
MVI achieves a more vaginal delivery rate within 24 h and Tachysystole events compared to MVT, however, no differences in caesarean section, operative vaginal delivery, and neonatal outcomes are reported.
Misoprostol vaginal insert versus dinoprostone vaginal insert: A comparison of labour and delivery outcomes.
A critical appraisal of the misoprostol removable, controlled-release vaginal delivery system of labor induction
TLDR
Current data suggest that the 100 μg MVI would provide the best balance between efficacy and safety, especially in high-risk situations needing induction of labor.
Oral misoprostol, low dose vaginal misoprostol, and vaginal dinoprostone for labor induction: Randomized controlled trial
TLDR
There was no significant difference in effectiveness of the three groups of induction at randomization, andound newborn acidemia, though infrequent, occurred only with low dose vaginal misoprostol.
Initial clinical experience with a misoprostol vaginal insert in comparison with a dinoprostone insert for inducing labor.
Efficacy and safety of misoprostol vaginal insert vs. oral misoprostol for induction of labor
TLDR
Time to delivery was significantly shorter in the MVI group with a higher rate of vaginal deliveries within the first 24 h, however, patients needed more opioids for pain relief during induction with MVI, and there was no difference in neonatal outcomes.
A comparison of misoprostol vaginal insert and misoprostol vaginal tablets for induction of labor in nulliparous women: a retrospective cohort study
TLDR
In a setting of routine obstetric care, MVI seems to be a more efficient labor induction agent than MVT, and with a lower CS rate and no increase in adverse infant outcomes.
The misoprostol vaginal insert compared with oral misoprostol for labor induction in term pregnancies: a pair-matched case-control study
TLDR
The MVI compared with OM significantly shortened the time from application to delivery at the expense of a higher cesarean section rate and negative effects on neonatal outcomes.
Clinical experience with misoprostol vaginal insert for induction of labor: a prospective clinical observational study
TLDR
When clinically indicated, MVI was efficient and safe for induction of labor in women with an unfavorable cervix, however, women should be counseled regarding the risk of uterine tachysystole prior to labor induction with MVI.
Standard and adjusted criteria for the use of the misoprostol vaginal insert for labor induction: a comparative cohort study
TLDR
The time from induction to delivery with MVI was similar when using standard criteria of up to 24 h of exposure vs. adjusted criteria ofup to 10 h of Exposure, and although the threshold for statistical significance for cesarean section was not attained, there is nonetheless a considerable difference between the MVI-24 and M VI-10 groups.
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