{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T01:24:14Z","timestamp":1771550654021,"version":"3.50.1"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"08","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geburtshilfe Frauenheilkd"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The efficacy, safety, and perinatal outcome of oral misoprostol (OM), a misoprostol vaginal insert (MVI), and a dinoprostone vaginal insert (DVI) for induction of labor at term was examined in a prospective multicenter cohort study (ethics committee vote 4154\u201307\/14). The primary aims of the study were the induction-birth interval (IBI), the cumulative delivery rates after 12\u00a0h, 24\u00a0h, and 48\u00a0h as well as the mode of delivery.<\/jats:p><jats:p>322 pregnant women were included in four German tertiary perinatal centers (MVI\u00a0110, DVI\u00a064, OM\u00a0148). They did not vary in age or BMI. Statistical analysis was carried out using a multivariate linear regression analysis and binary logistic regression analysis.<\/jats:p><jats:p>With regards to the median IBI, MVI and OM were equally effective and superior to the DVI (MVI 823\u00a0min [202, 5587]; DVI 1226\u00a0min [209, 4909]; OM 847\u00a0min [105, 5201]; p\u00a0=\u00a00.006). Within 24 hours, 64% were able to deliver with DVI, 85.5% with MVI and 87.5% with OM (p\u00a0&lt;\u00a00.01). The rates of secondary Caesarean sections (MVI 24.5%; DVI 26.6%; OM 18.9%) did not differ significantly. Uterine tachysystole was found in 20% with MVI, 4.7% with DVI and 1.4% with OM (p\u00a0&lt;\u00a00.001). A uterine rupture did not occur in any of the cases. Perinatal acidosis occurred (umbilical cord arterial pH &lt;\u00a07.10) in 8.3% with MVI, 4.7 with DVI and 1% with OM (p\u00a0=\u00a00.32). Neonatal condition was only impaired in three cases (5-minute Apgar score &lt; 5).<\/jats:p><jats:p>Induction of labor at term using the prostaglandins misoprostol and dinoprostone is an effective intervention that is safe for the mother and child. Oral application of misoprostol demonstrated the highest efficacy while maintaining a favorable safety profile.<\/jats:p>","DOI":"10.1055\/a-1860-0419","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T18:35:18Z","timestamp":1660156518000},"page":"868-873","source":"Crossref","is-referenced-by-count":2,"title":["Induction of Labor at Term with Oral Misoprostol or as a Vaginal Insert and Dinoprostone Vaginal Insert \u2013 A Multicenter Prospective Cohort Study"],"prefix":"10.1055","volume":"82","author":[{"given":"Jana","family":"Beyer","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Geburtsmedizin, Universit\u00e4tsklinikum Jena, Jena, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne","family":"J\u00e4ger","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Geburtshilfe, Krankenhaus St. Elisabeth und St. Barbara Halle, Halle, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derya","family":"Balci","sequence":"additional","affiliation":[{"name":"Frauenklinik, St. Joseph Krankenhaus Berlin-Tempelhof GmbH, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gelia","family":"Kolb","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Geburtsmedizin, Vivantes Klinikum Neuk\u00f6lln, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2903-391X","authenticated-orcid":false,"given":"Friederike","family":"Weschenfelder","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Geburtsmedizin, Universit\u00e4tsklinikum Jena, Jena, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven","family":"Seeger","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Geburtshilfe, Krankenhaus St. Elisabeth und St. Barbara Halle, Halle, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietmar","family":"Schlembach","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Geburtsmedizin, Vivantes Klinikum Neuk\u00f6lln, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Abou-Dakn","sequence":"additional","affiliation":[{"name":"Frauenklinik, St. Joseph Krankenhaus Berlin-Tempelhof GmbH, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekkehard","family":"Schleu\u00dfner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Geburtsmedizin, Universit\u00e4tsklinikum Jena, Jena, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"key":"ref2","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1055\/a-1495-8331","article-title":"Misoprostol in der Frauenheilkunde und Geburtshilfe \u2013 Brief an Spahn: gro\u00dfe Sorge\n          wegen erschwerten Zugangs zu Cytotec","volume":"81","author":"Deutsche Gesellschaft f\u00fcr Gyn\u00e4kologie und Geburtshilfe e.\u200aV.\n          (DGGG)","year":"2021","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1055\/a-1109-0170","article-title":"Stellungnahme der Deutschen Gesellschaft f\u00fcr Gyn\u00e4kologie und Geburtshilfe e.\u200aV.\n          (DGGG) und der Arbeitsgemeinschaft f\u00fcr Geburtshilfe und Pr\u00e4natalmedizin e.\u200aV. (AGG) in der\n          DGGG, der Deutschen Gesellschaft f\u00fcr Perinatale Medizin e.\u200aV. (DGPM), der Deutschen\n          Gesellschaft f\u00fcr Pr\u00e4natal- und Geburtsmedizin e.\u200aV. (DGPGM) sowie der\n          Bundesarbeitsgemeinschaft Leitender \u00c4rztinnen und \u00c4rzte in der Frauenheilkunde und\n          Geburtshilfe e.\u200aV. (BLFG) zur Berichterstattung \u00fcber \u201eCytotec zur\n          Geburtseinleitung\u201c","volume":"80","author":"Deutsche Gesellschaft f\u00fcr Gyn\u00e4kologie und Geburtshilfe e.\u200aV.\n          (DGGG)","year":"2020","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/j.ijgo.2012.12.009","article-title":"WHO recommendations for misoprostol use for obstetric and gynecologic\n          indications","volume":"121","author":"J Tang","year":"2013","journal-title":"Int J Gynaecol Obstet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1055\/a-1519-7713","article-title":"Induction of Labour. Guideline of the DGGG, OEGGG and SGGG (S2k, AWMF Registry\n          No.\u00a0015\u2013088, December 2020)","volume":"81","author":"S Kehl","year":"2021","journal-title":"Geburtshilfe Frauenheilkd"},{"issue":"06","key":"ref6","doi-asserted-by":"publisher","first-page":"CD014484","DOI":"10.1002\/14651858.CD014484","article-title":"Low-dose oral misoprostol for induction of labour","author":"RS Kerr","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/j.gofs.2021.11.011","article-title":"Efficacy and safety of oral misoprostol 25 \u03bcg vs. vaginal dinoprostone in\n          induction of labor at term","volume":"50","author":"H Bagory","year":"2022","journal-title":"Gynecol Obstet Fertil Senol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1055\/a-0834-8199","article-title":"Induction of Labour in Growth Restricted and Small for Gestational Age Foetuses \u2013\n          A Historical Cohort Study","volume":"79","author":"S Kehl","year":"2019","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1055\/a-1232-1418","article-title":"Fetal Growth Restriction \u2013 Diagnostic Work-up, Management and Delivery","volume":"80","author":"D Schlembach","year":"2020","journal-title":"Geburtshilfe Frauenheilkd"},{"issue":"05","key":"ref11","doi-asserted-by":"publisher","first-page":"CD004945","DOI":"10.1002\/14651858.CD004945.pub4","article-title":"Induction of labour for improving birth outcomes for women at or beyond\n          term","author":"P Middleton","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1055\/a-1538-2200","article-title":"Labour Induction with Misoprostol in German Obstetric Clinics: What Are the Facts\n          on Such Use?","volume":"81","author":"S Kehl","year":"2021","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.ejogrb.2014.11.026","article-title":"Off-label use of misoprostol for labor induction in Germany: a national\n          survey","volume":"187","author":"F Voigt","year":"2015","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1097\/AOG.0b013e31829a2dd6","article-title":"Misoprostol vaginal insert and time to vaginal delivery: a randomized controlled\n          trial","volume":"122","author":"DA Wing","year":"2013","journal-title":"Obstet Gynecol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/s00404-018-4942-y","article-title":"Clinical experience with misoprostol vaginal insert for induction of labor: a\n          prospective clinical observational study","volume":"299","author":"M Schmidt","year":"2019","journal-title":"Arch Gynecol Obstet"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.ejogrb.2018.07.025","article-title":"Misoprostol vaginal insert versus dinoprostone vaginal insert: A comparison of\n          labour and delivery outcomes","volume":"235","author":"K Rankin","year":"2019","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1111\/aogs.13667","article-title":"Labor induction with misoprostol vaginal insert compared with dinoprostone vaginal\n          insert","volume":"98","author":"C Maggi","year":"2019","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1111\/1471-0528.15796","article-title":"Slow-release vaginal insert of misoprostol versus orally administrated solution of\n          misoprostol for the induction of labour in primiparous term pregnant women: a randomised\n          controlled 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multicenter\n          trial","volume":"98","author":"E Hokkila","year":"2019","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1111\/jog.14230","article-title":"Do we need a 200\u00a0\u03bcg misoprostol vaginal insert? A retrospective cohort study\n          comparing the misoprostol vaginal insert to oral misoprostol","volume":"46","author":"S Wegener","year":"2020","journal-title":"J Obstet Gynaecol Res"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1515\/jpm-2020-0071","article-title":"Safety of misoprostol vaginal insert for labor induction using standard vs.\n          adjusted retrieval criteria: a comparative cohort study","volume":"48","author":"A Brandstetter","year":"2020","journal-title":"J Perinat Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"h217","DOI":"10.1136\/bmj.h217","article-title":"Labour induction with prostaglandins: a systematic review and network\n          meta-analysis","volume":"350","author":"Z Alfirevic","year":"2015","journal-title":"BMJ"}],"container-title":["Geburtshilfe und Frauenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1860-0419.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:07:14Z","timestamp":1758586034000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1860-0419"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8]]},"references-count":22,"journal-issue":{"issue":"08","published-online":{"date-parts":[[2022,8,10]]},"published-print":{"date-parts":[[2022,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1860-0419","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0016-5751","1438-8804"],"issn-type":[{"value":"0016-5751","type":"print"},{"value":"1438-8804","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8]]}}}