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Vaginal misoprostol for induction of labor: 25 vs. 50 μg dose regimen
Author(s) -
ElSherbiny M.T.,
ElGharieb I.H.,
Gewely H.A.
Publication year - 2001
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(00)00308-8
Subject(s) - misoprostol , medicine , group b , oxytocin , labor induction , regimen , group a , vaginal delivery , induction of labor , obstetrics , anesthesia , pregnancy , randomized controlled trial , gynecology , abortion , surgery , genetics , biology
Objective : To compare the efficacy and safety of two regimens of vaginal misoprostol for induction of labor. Method : In a randomized study, 185 women undergoing induction of labor were allocated to Group A ( n =93), to be given 25 μg misoprostol and Group B ( n =92), to be given 50 μg misoprostol. Intravaginal misoprostol was given every 4 h until the onset of labor. A maximum of six doses was administered. Results : Abnormal uterine contractions were more common in Group B compared to Group A: 33 (35.86%) vs. 10 (10.75%) cases, and significantly more women in Group B required tocolysis (9.78 vs. 3.23%). The induction‐delivery interval (mean±S.D.) was 17.18±8.48 h in Group A and 9.37±5.87 h in Group B ( P <0.05). Oxytocin infusion was used in 37.63% of women in Group A and 26.08% in Group B ( P >0.05). The cesarean section rate was 17.20% in Group A and 14.13% in Group B ( P >0.05). Cesarean for failed IOL was more common in Group A: 7 of 16 (43.8%) vs. 3 of 13 (23.1%) cesarean deliveries ( P <0.05). Postpartum hemorrhage occurred in 9.78% of women in Group B compared to 2.15% in Group A ( P <0.05). There was a trend for more neonatal complications in Group B, but this did not reach significance. Conclusions : Although a dose of 50 μg of misoprostol results in a significantly shorter induction‐delivery interval with less need for labor augmentation, there was an increased risk of uterine contractile abnormalities and postpartum hemorrhage. A regime using 25 μg of misoprostol every 4 h can induce labor safely and effectively.