Objectives: Small-for-gestational-age (SGA) pregnancy is a condition often leading to labor induction due to concerns about the possibility of an increased risk for fetal morbidity and mortality. In this retrospective cohort study, we try to evaluate the safety of oral misoprostol for labor induction in near-term and term pregnancies in SGA fetuses compared to dinoprostone as well as to planned primary cesarean section.
Materials and methods: Retrospective analysis of labor indution and primary cesarean section in SGA pregnancies 37 weeks and beyond in a tertiary care centre. In total, 284 consecutive patients with SGA fetuses were included. 80 recieved oral misoprostol, 85 dinoprostone as vaginal Gel and 119 were delivered by means of primary cesarean section. Primary endpoints were umbilical aterial pH and APGAR 5'. Secondary endpoints were APGAR 1' and 10', rates of relevant acidosis with a pH < 7.11 and depressed children, NICU admissions and vaginal operative deliveries as well as cesarean sections after labor induction.
Results: No significant differences were found concerning the umbilical arterial pH. No significant differences were found concerning APGAR 5' after labor induction; however, APGAR 5' was significantly lower after primary cesarean section. Similar results were found concerning APGAR 1', 10-min APGAR values were not significantly different. Rates of relevant acidosis and depressed children did not differ; no significant differences were found concerning NICU admissions between all groups and vaginal operative deliveries and CS rates after labor induciton.
Conclusion: Oral misoprosol is a safe method for labor induction in SGA near-term and term pregnancies and, concerning the neonatal outcome, comparable with other methods of labor induction or primary CS. Our study showed no adverse neonatal outcomes related to the use of oral misoprostol.
Keywords: Labor induction; Misoprostol; Small-for-gestational-Age.