Oral misoprostol and intracervical dinoprostone for cervical ripening and labor induction: a randomized comparison.

OBJECTIVE: To compare efficacy, safety, and tolerance of oral misoprostol with intracervical dinoprostone for cervical ripening and labor induction. METHODS: Two hundred women were randomized to receive single doses of oral misoprostol 200 microg or 0.5 mg of dinoprostone intracervically every 6 hours for a maximum four doses. RESULTS: The intervals from administration of the drug to active phase of labor (11.1 hours [7-24] versus 15.8 hours [7.5-29.62], P =. 01), to delivery (14.0 hours [8.42-27.61] versus 20.2 hours [16.7-32. 8], P =.01), and to rupture of membranes (10.0 hours [4.95-24.7] versus 15.6 hours [8.2-29.2], P =.003) were significantly shorter in the misoprostol group. All those variables were not distributed normally, so results are presented as median and interquartile range. The rates of women who needed oxytocin (68% versus 52%, P =.03) and cesarean for failed induction (9% versus 1%, P =.01) were higher in the dinoprostone group. CONCLUSION: A single dose of 200 microg oral misoprostol was more effective for cervical ripening and labor induction than 0.5 mg of dinoprostone intracervically every 6 hours, with a maximum of four doses.

[Adolescence and contraception]. / Adolescencia y contracepción.

The birthrate has decreased for all age groups except for adolescents. 4.51% of all pregnancies in Spain fall within the 15-19 year old age group. The prevention of adolescent pregnancy indicates the need for making family planning services more accessible to young people. The object of this study was a review of medical consultations performed in 1993 with adolescents at a family planning service. Among the most significant results are the following: the average age of menarche and coitus primaris was 11.8 years (+ or -2.2 years) and 16 years (+ or -1.7) respectively. The period between coitus primaris and the act of going to a family planning center was 9.1 months (+ or -2.3). 81.7% of those adolescents were advised to take oral contraceptives, 12.4% condoms, 1.96% the I.U.D. and 3.9% none. Among the most common side effects noted after taking oral contraceptives for 6 to 12 months were: psychic alterations (changes of mood, etc.), spotting, digestive upset, migraines and weight increase. The number of sexual partners before and after contraceptive use did not change significantly.

[Neurologic alert signals in one-year-old infants: relation to signs of intrapartum hypoxia]. / Signos neurológicos de alerta al año de vida: relación con los signos de hipoxia intraparto.

As a method to evaluate the neurologic evolution and to establish if there exists any differences in the relation with the signs of intrapartum hypoxia, we have explored the neurologic "alert signs" at a certain age (12 months of life) in 80 full-term newborn infants with normal weight and without criteria of neurologic risk. We did not find statistically significant differences in the presence of alert signs in regards to sex, gestational risk, type of amniotic fluid, way of delivery, one-minute and five-minute Apgar scores or acid-base state in the umbilical artery at birth. We did find a significant increase in the number of alert signs in patients with cardiotocographic patterns that were suspicious or not tranquil in relation to those whose cardiotocographic patterns were tranquil.

[The cardiorespirogram in the first 12 hours of life. Relation to the form of termination of labor]. / Estudio del cardiorrespirograma en las primeras doce horas de vida. Relación con la forma de terminación del parto.

Cardiorespirography is a method of monitoring which establishes a correlation between cardiac and respiratory activity. During the first twelve hours following birth cardiorespirographic parameters undergo a series of evolutionary modifications, becoming stable between the sixth and twelfth hours. Authors analyse how the manner in which birth is terminated influences parameters during first twelve hours. In the case of caesarean births they find only one instance of diminishing accelerations during the first hour, and in spontaneous births, a reduced number of instances of decelerations are registered during first and sixth hour. They believe that these findings are due to drugs administered during birth rather than to the manner in which this was achieved.

[Cardiorespirographic parameters in the first 12 hours of life. Influence of the administration of thiopental and diazepam plus thiopental on labor]. / Parámetros cardiorrespirográficos en las primeras doce horas de vida. Influencia de la administración de tiopental y diacepam más tiopental en el parto.

Cardiorespirographic parameters undergo a series of evolutionary modifications during first hours of life, becoming stable between the sixth and twelfth. The authors analyse how these parameters are influenced by the administration to the mother of thiopental and diazepam plus thiopental during birth. They observed a significant reduction, during the first hour after birth, in the range and frequency of accelerations in the newborn babies whose mothers had been administered one of the drugs. Also, they observed a greater number of cases of decelerations in the newborns who were given drugs. No significant differences were observed in other parameters, and after the twelfth hour no differences were observed at all.