Abstract
Background: Misoprostol a PGE1 analogue has increasingly been used for cervical ripening in preparation for induction of labour with variable outcome for both mother and baby. Objectives: To determine the effectiveness of Misoprostol in cervical ripening and labour outcome in Aminu Kano Teaching Hospital Kano. Study Design: A study of all patients who had cervical ripening for induction of labour using Misoprostol at AKTH Kano, Nigeria, between 1st Jan 2012-31st Dec 2013. Socio-demographic data of these patients including number of doses inserted before ripening is achieved, duration, course and outcome of labour were documented. Result: Four hundred and two women were admitted for cervical ripening. 365 women met the inclusion criteria out of the 358 folders retrieved, giving a retrieval rate of 98%. Despite this six folders did not contain enough information for the study and were excluded leaving us with a sample size of 352. They had a successful cervical ripening with an average of 2 insertions. Spontaneous onset of labour without further intervention was observed in 266 women (75.5%). However, 86 women (24.5%) were induced with oxytocin following cervical ripening. The mean duration of labour among those that had spontaneous onset of labour following Misoprostol insertion was 9.8 hours. 96% of the patients had vaginal delivery while 4% had Caesarean section. Conclusion: Misoprostol was associated with favorable outcome following cervical ripening with a low caesarean section rate.
Highlights
The aim of induction of labour is to achieve vaginal delivery, it presents a challenge to an obstetrician when the cervix is unfavorable
Misoprostol is increasingly being used for cervical ripening, as it often results in spontaneous onset of labour [3] [4], and may replace the traditional Foley’s catheter/oxytocin protocol [3] [4]
During the period of study, 482 patients were admitted for cervical ripening, 365 patients met the inclusion criteria but 358 folders were retrieved, giving folder retrieval rate of 98%
Summary
The aim of induction of labour is to achieve vaginal delivery, it presents a challenge to an obstetrician when the cervix is unfavorable. Misoprostol is increasingly being used for cervical ripening, as it often results in spontaneous onset of labour [3] [4], and may replace the traditional Foley’s catheter/oxytocin protocol [3] [4]. It is a stable synthetic 15 deoxy 16 methyl analogue of naturally occurring PGE1 which was originally introduced as a therapy for gastric ulcer but widely found to be useful in reproductive health [5]-[7]. Conclusion: Misoprostol was associated with favorable outcome following cervical ripening with a low caesarean section rate
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