Korean J Obstet Gynecol.  2002 Mar;45(3):438-442.

Comparison of Two Dose Regimens of Misoprostol for Cervical Ripening and Labor Induction

Affiliations
  • 1Departments of Obstetrics and Gynecology, Chonnam National University Medical School and Chonnam National University Research Institute of Medical Sciences, Kwangju, Korea.

Abstract


OBJECTIVE
To compare the safety and efficacy of two dose regimens of intravaginally administered misoprostol (PGE1) for cervical ripening and labor induction.
METHODS
One hundred patients with unfavorable cervix (including PROM) for labor induction were randomly assigned to group A and group B. Group A patients received 25 g of vaginal misoprostol every 4 hours with maximum of 6 doses and group B patients received 25 g, 50 g, 100 g, 100 g of misoprostol every 4 hours with maximum of 4 doses. Misoprostol was inserted to the posterior vaginal fornix. Successful induction was defined when Bishop score was increased to greater than 9 or regular uterine contractions were developed. The rates of successful induction, vaginal delivery, mean time from induction to delivery, drug side effects, and neonatal outcomes were compared.
RESULTS
The average interval from start of induction to vaginal delivery was shorter in group B (780.1+/-313.0 minutes) than group A (1108.9+/-485.9 minutes) (p<0.01). The rate of vaginal delivery was higher in group B (42/50, 84.0%) than group A (35/50, 70.0%) although statistically not significant. The incidences of tachysystole, abnormal fetal heart rate tracing, meconium passage, low 1-min and 5-min Apgar scores, and admission to the neonatal intensive care unit were not different between two groups.
CONCLUSIONS
Induction with misoprostol using dose-increasing schedule showed shorter time from induction to delivery and higher rate of successful induction than using same dose schedule without increase of side effects and adverse neonatal outcomes.

Keyword

misoprostol; labor induction; cervical ripening; regimen

MeSH Terms

Appointments and Schedules
Cervical Ripening*
Cervix Uteri
Female
Heart Rate, Fetal
Humans
Incidence
Infant, Newborn
Intensive Care, Neonatal
Meconium
Misoprostol*
Pregnancy
Uterine Contraction
Misoprostol
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