Oral prostaglandin safer than vaginal for induction?
Labor induction using an oral prostaglandin solution is less effective than a vaginal prostaglandin gel for achieving vaginal birth within 24 hours, but is a safer option because it is associated with a lower rate of cesarean delivery, according to the results of a new retrospective study.1
“CS [cesarean delivery] increases risks for maternal complications of placenta previa, placenta accreta, massive obstetric bleeding, and peripartal hysterectomy, and the risk of CS is increased by labor induction and after a woman delivers by CS,” said Ylva Vladic Stjernholm, Docent/Associate Professor, Department of Women’s and Children’s Health, Karolinska University Hospital, Stockholm, Sweden.
“With the goal of minimizing maternal morbidity and mortality, we recommend using an oral prostaglandin rather than a vaginal prostaglandin for labor induction because the oral formulation minimizes the probability for CS.”
The investigators undertook their study recognizing that induced labor rates have been increasing in many areas of the world in the past few decades. In Sweden, the rate more than doubled over a 20-year period from 7% of all childbirths in 1992 to 16% in 2012–2013.