The effect of misoprostol on fetal heart rate parameters during induction of labour from 38 weeks gestation : a retrospective audit

[摘要] ENGLISH ABSTRACT: Misoprostol is often used for the purpose of induction of labour. However, its effect on fetal heart rate has not been systematically studied.ObjectiveTo assess the effect of misoprostol on fetal heart rate parameters during induction of labour from 38 completed weeks in women with previous intrauterine death or postterm pregnancy.Study designA retrospective descriptive study of 127 women for a period of 18 months.MethodWomen who underwent induction of labour with misoprostol for either previous intrauterine death or postterm pregnancy at Tygerberg hospital were eligible.The selected process of induction of labour happened according to the departmental protocol. The primary outcomes were changes in fetal heart rate (variability, accelerations and decelerations) pre-and post-administration of misoprostol. Secondary outcomes were neonatal highcare or intensive care unit (ICU) admissions.ResultsThere was no statistical difference in the mean fetal heart rate and baseline variability in relation to time recordings after administration of misoprostol. There were no statistically significant differences in the distribution of accelerations and decelerations in different time intervals before and after administration. There were more reactive patterns at all time intervals after the administration of misoprostol, but these differences did not quite reach statistical significance. In both study groups no neonatal complications or intensive care admissions were reported.ConclusionIn the absence of contra indications, 50mcg of oral misoprostol can be given to mothers for induction of labour as no harmful fetal heart tracing abnormalities were found for 45 minutes; however large prospective randomized controlled trials are still needed to confirm effectiveness and evaluate further maternal and neonatal safety issues. Optimal dose and frequency also still need robust interrogation. Based on this thesis it does appear that misoprostol is probably not harmful to the fetus under these circumstances.

[发布机构] Stellenbosch University