Dinoprostone outperforms misoprostol at inducing labour

Vaginal dinoprostone appears to be a better labour-inducing agent than vaginal misoprostol, leading to lower rates of foetal complications, a recent study has found.

Researchers conducted a retrospective, single-centre analysis of 904 women, 656 of whom were given vaginal misoprostol to induce labour, while 248 received dinoprostone.

The primary outcome was vaginal delivery, while secondary endpoints included induction failure, time from induction to the beginning of the active phase of labour, duration of labour, and maternal and foetal mortality and morbidity.

The rate of vaginal delivery in the dinoprostone group was 88.7 percent, as opposed to only 82.3 percent in the misoprostol-induced women (p=0.016). Conversely, caesarean delivery was significantly more common in the misoprostol group (17.7 percent vs 11.3 percent).

Of note, women given misoprostol were significantly more likely to report abnormal foetal heart rate as a reason for opting for caesarean delivery (65.5 percent vs 50 percent; p=0.005).

Similarly, normal vaginal delivery was significantly higher in the dinoprostone group (71.4 percent vs 61.9 percent; p=0.007), while slightly more women in the misoprostol arm needed help from instruments (20.4 percent vs 17.34 percent; p=0.29).

In contrast, the time from induction to labour onset was significantly shorter with misoprostol (7 hours and 17 minutes vs 11 hours and 58 minutes; p<0.001), as was the duration of active labour (5 hours and 34 minutes vs 6 hours and 21 minutes; p=0.0023).