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Pilot study of labor induction with titrated oral misoprostol
Shi-Yann Cheng1, Tai-Chang Chen
1Department of Obstetrics and Gynecology, China Medical University Peikang Hospital, Yun Lin, Taiwan. shiyann@ms18.url.com.tw
Objective:
To evaluate the safety and efficacy of titrated oral misoprostol for labor induction at term.
Materials And Methods:
Seventy-seven pregnant women (37 nullipara and 40 multipara), with medical or obstetric indications for labor induction after 37 weeks of gestation and unfavorable cervices (Bishop's score < 7), were induced according to the principles of titrated oral doses of misoprostol against uterine response. Our primary outcome measurements were the percentage of patients who had a vaginal delivery within 24 hours of induction and the interval from induction to vaginal delivery. Secondary measurements included oxytocin requirement, total misoprostol dosage, number of cesarean deliveries, induction failure, uterine hyperstimulation rates and neonatal outcomes.
Results:
Seventy-five women (97.4%) experienced active labor within 24 hours, with 72 (93.5%) completing vaginal delivery within 24 hours. The mean interval from induction to vaginal delivery for all the women was 9.7 hours, with a 2.3-hour active phase. The mean misoprostol dosage was 206 microg, with eight women (10.4%) requiring oxytocin augmentation. There was no uterine hyperstimulation or induction failure, except for seven cases of uterine tachysystole (9.1%).
Conclusion:
Titrated oral misoprostol is a safe and effective method of labor induction because the dosage can be adjusted according to individual response.
