[Vaginal application of misoprostol for labor induction after 36 weeks of pregnancy]

The aim of this study was to confirm efficacy and safety of misoprostol in induction of labour in patients in late pregnancy.

Misoprostol 50 microg tablets were applied in the posterior vaginal fornix in 130 primigravidae which were (Bishop score 6 or <6) in late pregnancy. In the first group (61 patients), misoprostol was applied every 4 hours, while in the second group (69 patients) every 6 hours. Up to five misoprostol doses were applied. Our aim was to determine an induction delivery interval (interval from applied first dose of misoprostol until delivery), method of delivery as well as side effects which can occur using misoprostol.

Mean value induction delivery interval was 13 hours and 39 minutes (SD = 4.21 P = 0.268) in the group where misoprostol was applied every 4 hours, and 15 hours and 44 (SD = 2.54 P = 0.206) minutes in the group where misoprostol was applied every 6 hours. The average number of misoprostol doses is 2.22 in the group where applied at 4 hours, and 2.33 at the group where applied at 6 hours. Success of induction was 97.7%. Occurrence of labor within 12 hours was 60.4% in the first group and 49.5% in the second group. Caesarean section rate was 13.11% of patients in the first group, and 11.47% of patients in the second group. Tachysystole appeared in 4.9% of patients in the first group and in 3% of patients in the second group. Hyperstimulation was noted in two cases (3%) of patients to whom misoprostol was applied every 4 hours. Labor has been completed with vacuum extractor and forceps in 5% of patients in the first group and 2.8% of patients in the second group.

Insertion of misoprostol dose of 50 microg in the posterior vaginal fornix resulted in successful cervical ripening, successful labor induction, low incidence of hyperstimulation, without side effects, and labour has been completed with relative lower cesarean section rate. Misoprostol is a safe medication for both mother and baby.