Complications associated with second trimester inductions of labor requiring greater than five doses of misoprostol^.

To evaluate outcomes associated with induction at 14 weeks 0 days-23 weeks 6 days gestation that require five or less vs. six or more misoprostol doses.

We performed a retrospective study of vaginal misoprostol inductions from January 2003 to February 2016 to assess complications based on number of misoprostol doses.

Among 390 women receiving five or fewer doses and 78 women receiving six or more doses, we found similar rates of chorioamnionitis, postpartum hemorrhage, transfusion and retained placenta.

Complication rates were comparable in women receiving more than five versus less than five misoprostol doses for labor induction in the second trimester.

Women undergoing second trimester induction undelivered after five doses of misoprostol can receive additional doses without any concern for increased complications.