Labor induction with dinoprostone or oxytocine and postpartum disseminated intravascular coagulation: A hospital-based case-control study

AbstractAim:To compare the efficacy and safety of the misoprostol vaginal insert (MVI) with an off-label use of oral misoprostol (OM).Methods:Pair-matched case-control study comparing the induction of labor with a retrievable MVI to OM. The primary outcomes were the time from induction to delivery and the cesarean section rate. Secondary outcomes included uterine tachysystole, tocolysis, fetal scalp blood testing, meconium-stained amniotic fluid, umbilical arterial pH, and Apgar score.Results:One hundred and thirty eight women ≥37/0 weeks pregnant undergoing labor induction with misoprostol were included. The mean time from application to delivery was significantly shorter and the caesarean section rate significantly higher in the MVI group (P<0.01) with an odds ratio of 2.75 (95% CI: 1.21–6.25) in favor of vaginal delivery in the OM group. The mean 5-min Apgar scores and arterial cord pH values were significantly lower in the MVI group. An arterial pH value of 7.10–7.19 was found in 26.1% and 15.9%, and a value <7.10 was found in 4.3% and 0% of MVI and OM cases, respectively.Conclusion: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.

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Labor Induction And The Incidence of Intrapartum Maternal Fever In Epidural Labor Analgesia: A Retrospective Case-Control Study

10.21203/rs.3.rs-102668/v1 ◽

2020 ◽

Author(s):

Min Wang ◽

Yiting Li ◽

Zhongya Gu ◽

Duan Manlin

Keyword(s):

Case Control Study ◽

Tertiary Hospital ◽

Case Control ◽

Labor Induction ◽

Labor Analgesia ◽

Short Term ◽

Retrospective Case ◽

Term Outcome ◽

Increased Risk ◽

Control Study

Abstract Background: To assess the influence of labor induction on the intrapartum maternal fever in epidural labor analgesia and to determine its association with intrapartum fever.Methods: A retrospective case-control study was performed during 2016–2018 in a first-class tertiary hospital. All patients who received epidural labor analgesia were allocated into either case (parturients who received labor induction and had intrapartum fever) or control (parturients who did not receive labor induction but had intrapartum fever) groups. Maternal demographic and intrapartum data, epidural infusions records, and neonatal short-term outcome were studied.Results: A total of 710 epidural labor analgesia occurred during the study period and 119 (16.76%) women had intrapartum fever. Intrapartum fever occurred in 66 (25.68%) women who received labor induction and in 53 (11.70%) who did not. After correction for confounding factors, labor induction (OR 2.818, 95% CI, 1.778–4.467, P<0.001), number of vaginal examinations (OR 1.242, 95% CI, 1.048–1.471, P=0.012), baseline maternal temperature (OR 6.702, 95% CI, 2.065–21.755, P=0.002), admission white blood cell count (OR 1.171, 95% CI, 1.052–1.303, P=0.004), and neonatal birth weight (OR 3.015, 95% CI, 1.739–5.227, P<0.001) were risk factors for intrapartum maternal fever during epidural labor analgesia.Conclusion: Labor induction was significantly associated with an increased risk of intrapartum maternal fever during epidural labor analgesia.

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