Estudio comparativo de misoprostol vs. dinoprostona para la inducción del trabajo de parto
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Objetivo. Comparar la seguridad, eficacia y costo del misoprostol intravaginal (análogo de la prostaglandina E1) y la dinoprosfona intracervical (prostaglandina E2 en la inducción del trabajo del parto con cérvix inmaduro (índice de Bishop < 6). Método. Ochenta y cuatro pacientes se asignaron al azar a uno de los dos grupos: 1) 43 al de misoprostol intravaginal (50 µg) y 2) 41 al de dinoprostona intracervical (0.5 mg), ambos medicamentos se administraron a intervalos de 6 horas, con un máximo de 3 dosis. Resultados. Las pacientes con misoprostol tuvieron una reducción significativa en el tiempo entre la administración del medicamento y la fase activa del trabajo de parto (500.3 ± 310 contra 647 ± 341 min.) (p = 0.039). El tiempo de trabajo de parto se acortó significativamente con el misoprostol (652 ± 311 contra 829.9 ± 359 min.) (p = 0.022). Las complicaciones intraparto como taquisistolía, meconio y síndrome de hiperestimulación uterina ocurrieron en forma similar en los dos grupos. El porcentaje de partos vaginales, efectos adversos maternos y el seguimiento neonatal no fueron estadísticamente diferentes. Conclusiones. El misoprostol es más efectivo que la dinoprostona para alcanzar la fase activa del trabajo de parto y el parto. Tiene la misma seguridad para el feto y la madre y su costo es mínimo.
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