Evidence map›Paper›PMID 31188317›Full record

ArticleObstetrics and gynecology2019

Oral or Vaginal Misoprostol for Labor Induction and Cesarean Delivery Risk.

Roxane C Handal-Orefice, Alexander M Friedman, Sujata M Chouinard, Ahizechukwu C Eke, Bruce Feinberg, Joseph Politch, Ronald E Iverson, Christina D Yarrington

Registry-linked trialOpen access · bronzeAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Obstetrics and gynecology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05262738 (Misoprostol Dosing in BMI Greater Than 30), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.8field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05262738 phase4completednot on this mapstarted 2022, after this paper: background citation

Misoprostol Dosing in BMI Greater Than 30: A Randomized Controlled Trial

TypeinterventionalSponsorUniversity of Texas at AustinRan2022 to 2023Enrolled180ConditionsPregnancy Related, Obesity, Labor Onset and Length AbnormalitiesArms50 Micrograms Vaginal Misoprostol (Intervention), 25 Micrograms Vaginal Misoprostol (Control)
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 23 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Roxane C Handal-OreficeDepartment of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, New York; the Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico; the Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, Maryland; the Department of Obstetrics and Gynecology, Boston University Medical Center, Boston, Massachusetts.
Alexander M Friedman
Sujata M Chouinard
Ahizechukwu C Eke
Bruce Feinberg
Joseph Politch
Ronald E Iverson
Christina D Yarrington
Columbia University · USJohns Hopkins University · USUniversity of New Mexico · US

Funding

Clinical Pharmacology Training ProgramT32GM066691 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI Matthew Michael Ippolito · 2003 to 2026
$6.4M
NIGMS NIH HHS T32 GM066691
6 · The paper itself

Abstract

objectiveTo evaluate whether cervical ripening with oral misoprostol increases cesarean delivery risk and prolongs time to vaginal delivery compared with vaginal misoprostol in a predominantly overweight population.

methodsThis single center, retrospective cohort study was performed at a tertiary care academic medical center and compared labor induction outcomes with vaginal misoprostol to outcomes with oral misoprostol after a complete institutional shift to oral misoprostol. Labor induction using 25 micrograms vaginal misoprostol in 2013-2014 was compared with 50 micrograms oral misoprostol in 2014-2015. The primary outcome was cesarean delivery. Secondary outcomes included time to vaginal delivery, uterine tachysystole, maternal hemorrhage, and composite adverse neonatal outcomes. Demographics and outcomes were analyzed using standard statistical tests. Multivariable regression models accounting for potential confounders were created for the primary and secondary outcomes with adjusted odds ratios (aOR) as the measures of effect.

resultsThere were 138 women in the oral and 138 women in the vaginal misoprostol groups. In the overall cohort, the median (interquartile range) body mass index was 31.7 (28.2-36.8) and most women (72%) were of either black or Hispanic race or ethnicity. The frequency of cesarean delivery was higher in the oral than the vaginal misoprostol group (32% vs 21%; P=.04). The adjusted odds of cesarean was higher with oral misoprostol (aOR 2.01; 95% CI 1.07-3.76). Among nulliparous women, the frequency of cesarean delivery was 41% in the oral and 28% in the vaginal misoprostol groups (aOR 2.79; 95% CI 1.26-6.19). Women had a longer time to vaginal delivery in the oral compared with vaginal misoprostol group (41 vs 31 hours respectively, P=.01). Tachysystole occurred more frequently with vaginal misoprostol (20% vs 11%; P=.04).

conclusionCompared with vaginal misoprostol, oral misoprostol may be associated with increased risk of cesarean delivery and longer time to vaginal delivery.

Indexed as

Labor, InducedAdministration, IntravaginalAdministration, OralAdultCesarean SectionCohort StudiesDelivery, ObstetricFemaleHumansMisoprostolOxytocicsPregnancyRetrospective StudiesRisk FactorsTreatment OutcomeMisoprostolOxytocics

Identifiers

PMID31188317
PMCPMC9234943
OpenAlexW2951837251

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.