Misoprostol For Labor Induction Research Articles

A Comparative Study of Sublingual and Vaginal Low Dose Misoprostol for Induction of Labor

A Comparative Study of Sublingual and Vaginal Low Dose Misoprostol for Induction of Labor

To Compare the Efficacy and Safety of Misoprostol for Induction of Labour at Term Singleton Pregnancies by Intravaginal versus Sublingual Route

To Compare the Efficacy and Safety of Misoprostol for Induction of Labour at Term Singleton Pregnancies by Intravaginal versus Sublingual Route

Effectiveness of Sublingual Versus Oral Misoprostol for Induction of Labour at Term

Effectiveness of Sublingual Versus Oral Misoprostol for Induction of Labour at Term

Comparison between use of oral misoprostol versus vaginal misoprostol for induction of labour at term

Comparison between use of oral misoprostol versus vaginal misoprostol for induction of labour at term

Comparative study of efficacy of intracervical foley catheter with intravaginal misoprostol in induction of labour in primigravida with term pregnancy

Comparative study of efficacy of intracervical foley catheter with intravaginal misoprostol in induction of labour in primigravida with term pregnancy

Effectiveness of Sublingual Versus Oral Misoprostol for Induction of Labour at Term

Objective: To compare the efficacy and safety of 50microgram (mg) sublingual Misoprostol with 50 microgram (mg) oral misoprostol for labour induction at term. Method: One hundred twenty women with medical or obstetric indication for induction of labour at term with unfavorable cervix were randomized to receive 50mcg of misoprostol either orally or sublingually. Primary outcome was number of women delivering vaginally within 24hrs of induction. The need for oxytocin, mode of delivery, doses of Misoprostol required and neonatal outcomes were analyzed and compared between the groups. Results: Induction to vaginal delivery time was < 24hours in 43(71.7%) in sublingual group and 36(60%) women delivered vaginally in < 24hours in oral group. No significant difference was found in the number of women delivering vaginally within 24hrs of induction among both the groups.Time from administration of first dose to delivery in sublingual group was lesser compared to oral group. 46.7% of women required oxytocin in sublingual groups, whereas 75% in oral group which was statistically significant. Sublingual group had lesser number of women requiring more than 1 dose of misoprostol compared to the oral group. Conclusion: Sublingual misoprostol seems to be having better efficacy than the oral misoprostol and has lesser induction to delivery interval. Hence can be considered to induce labour at term for ripening of cervix.

Comparative Study of Sublingual versus Vaginal Misoprostol for Induction of Labour

Comparative Study of Sublingual versus Vaginal Misoprostol for Induction of Labour

Randomized controlled trial between sublingual and vaginal misoprostol for induction of labour at term

spontaneous onset of labor, with or without rupture of membranes. When the cervix is unfavorable, cervical ripening with prostaglandins to soften and open the cervix will often commenced to induce labor.Objective: To compare 50 μg of sublingual misoprostol to 50 μg of vaginal misoprostol for induction of labour at term regarding efficacy and safety.Patients and Methods: This prospective randomized controlled trial included 104 pregnant women who were recruited from Department of Obstetrics and Gynecology, Faculty of Medicine Ain-Shams University and Al-Glaa Teaching Hospital, Delivery Unit.Results: Regarding induction-delivery interval (time from given drug for both groups to vaginal delivery), there was no significant statistical difference between both groups regarding the mean time from initial dose to the delivery. Mean 15.04 ± 4.67 for sublingual group versus 14.16 ± 4.45 for vaginal group (P= 0.331). As regarding fetal and maternal complications in our study, there was significant statistical difference between the vaginal and sublingual groups according to secondary outcome (hyperstimulation). The risk of hyperstimulation was higher in vaginal group (5 cases) compared to the sublingual group (No cases) P= 0.046.Conclusion: Sublingual misoprostol 50 μg administered at 6 hourly intervals is as effective in promoting cervical ripening and inducing labor as vaginal misoprostol 50 μg administered 6 hourly intervals as regarding induction to delivery interval, number of doses, shorter hospitalization and neonatal outcome. Sublingual misoprostol 50 μg has a higher maternal and perinatal safety profile than the vaginal 50 μg misoprostol including cesarean rates due to fetal distress, adverse maternal outcomes as hyperstimulation.Recommendations: We recommend sublingual 50 μg misoprostol administered at 6 hourly intervals as an efficacious and safe option for labor induction, low cost and availability is its added benefits

Oral misoprostol for induction of labor at term: a randomized controlled trial of hourly titrated and 2 hourly static oral misoprostol solution

Background: Misoprostol has been shown to be effective in induction of labor (IOL) with different dosages and routes of administration.Objectives: This study compared the efficacy and safety of hourly titrated and 2-hourly static low dose oral misoprostol for IOL in Ekiti State University Teaching Hospital, Ado-Ekiti.Methods: One hundred fifty women with singleton pregnancy at term admitted for IOL were randomized into the two groups. Oxytocin augmentation was done as necessary. The primary outcome is rate of vaginal delivery within 24 hours. Data were analyzed using SPSS.Results: Vaginal delivery was achieved within 24 hours in 40 (67.8%) women who received hourly titrated-doses oral misoprostol and 42 (70.0%) women who received 2-hourly static-dose of oral misoprostol, p > .05. The rate of vaginal delivery, oxytocin augmentation, induction delivery time and cesarean section rate were similar in both groups, p > .05. Occurrence of uterine hyperactivity did not differ significantly among the women (p > .05) and no cases of uterine rupture were recorded. There were no adverse neonatal outcomes.Conclusions: The hourly titrated oral misoprostol is as effective and safe as the 2-hourly static oral misoprostol for IOL. Both can be utilized in IOL without the fear of adverse outcomes.

Oral Misoprostol Solution in Comparison to Vaginal Misoprostol in Induction of Labor

Oral Misoprostol Solution in Comparison to Vaginal Misoprostol in Induction of Labor

A comparison of oral versus vaginal misoprostol for induction of labor at term, at the Ahmadu Bello University Teaching Hospital, Zaria

Background: The comparison of same,equal and low dose of misoprostol by the oral and vaginal routes for induction of labour at term requires further elucidation. Objective: To compare the efficacy and safety of 25 micrograms (ug) of oral misoprostol with 25ug vaginal misoprostol for induction of labor at term.Methods: A randomised control trial that involved 169 consented women with indication for induction of labor. A total of 85 women had oral misoprostol while 84 women had vaginal misoprostol. The oral misoprostol dose (25ug) was repeated every 2 hours, while the vaginal dose (25ug) was repeated every 6 hours for a maximum duration of 24 hours or when need arose for intervention. Data was analysed using SPSS version 20. Results: The mean induction-delivery interval was significantly shorter (18.48 +/- 2.01 vs. 22.82 +/- 2.50, P = 0.00), with more vaginal deliveries (88.2% vs. 85.7%, P = 0.00) in the oral group compared to the vaginal group respectively. The cardiotocographic abnormalities in the vaginal group were significantly higher than the oral group (8.3% vs. 1.2%, P = 0.03). There were more foetal distress and meconium stained liquor in the vaginal group but not statistically significant.

Stripping of membranes versus vaginal misoprostol in induction of labor

Background The objective of this study was to evaluate the safety and efficacy of membrane stripping and vaginal misoprostol in the induction of labor in low-risk patients at term pregnancy (38–40 gestational weeks). Aim This study was done to compare the efficacy and safety of the two techniques for cervical ripening/labor induction by stripping of membranes and low-dose vaginal misoprostol on the outcome of labor induction in singleton pregnancies between 38 and 40 weeks. Patients and methods This prospective study was conducted for 9 months. The study included 100 women divided randomly into two groups: group I (n = 50) in which stripping of membranes was performed and group II (n = 50) which received intravaginal misoprostol. In group I, stripping of membranes was performed to be repeated after 48 h then followed up within 72 h of the first visit. In group II, patients received 25 μg vaginal misoprostol tablets every 6 h with a maximum of four doses after admission for follow-up of fetal well-being and observations of the route of delivery and indication of cesarean section. Time interval from the start of induction to the delivery time and need for oxytocin augmentation and labor complications were observed. Outcome data as fetal weight, Apgar scores at 1 and 5 min, and need for admission to neonatal ICU were recorded. Results Stripping of membranes is as effective as vaginal misoprostol, but the induction-delivery interval was significantly lower in misoprostol. There were no statistically significant differences between the two groups in the results of neonatal outcome. Conclusion Both methods were effective and safe in the induction of labor; however, misoprostol needs hospital admission, with no increases in the risk of neonatal outcome and minimal adverse effects.

Outcome of induction of labor with prostaglandin E1 25 mg vaginal tablet – A retrospective study

Context: Labor induction with prostaglandin E1 (PGE1) vaginal tablet results in shorter induction delivery interval and decreased rate of failed induction of labor and reduced caesarean section rate. However, higher doses may be associated with uterine hyper stimulation. It is therefore necessary to determine the safe dose of PGE1 for labor induction. Aims: To assess the maternal and neonatal outcome with use of 25 mg vaginal misoprostol for induction of labor. Settings and Design: A retrospective analysis conducted in an obstetric department of a tertiary care teaching institute. Materials and Methods: The sample consists of women with singleton term pregnancy, with Bishop's score Statistical Analysis Used: Statistical significance was assessed at 5% level of significance. Chi-square test, with correction for continuity where applicable, was carried out to compare proportions across subgroups or between induction and spontaneous onset groups. Results: The rate of vaginal delivery was higher among spontaneous onset group compared with induction group (χ2 (1) = 30.3, P Conclusion: Our study showed a higher rate of vaginal delivery with induction delivery interval less than 24 h in a majority of women with better neonatal and maternal outcomes.

Use of misoprostol for induction of labor in full term pregnancy- A randomised control trial

Use of misoprostol for induction of labor in full term pregnancy- A randomised control trial

Combined Rupture of Vaginal Vault and Unscarred Uterus and Neonatal Death Following Induction of Labor with Misoprostol

Introduction: Rupture of unscarred uterus (primary uterine rupture) is a rare peripartum complication often associated with catastrophic maternal and neonatal outcomes. Case presentation: A 27-year-old primigravid lady, previously healthy, at 40 weeks + 2 days presented to a midwife’s clinic for routine antenatal consultation. She was advised to have induction of labor. This was initiated with 2 tablets of Misoprostol (400 mcg) vaginally. Twelve hours later, and after remaining at full cervical dilation for 4 hours, she was referred to our maternity service for alleged failure to descend. On arrival, she was apprehensive, exhausted but hemodynamically stable. Pelvic exam disclosed a fully dilated cervix with the vertex at S + 1 and a caput reaching the introitus. No fetal heart rate could be elicited by the CTG monitor and this was verified by a bedside ultrasonography. Operative vaginal delivery was performed due to maternal exhaustion. This was complicated by transient shoulder dystocia. Manual revision of the birth canal and the uterine cavity disclosed a suspicion of left vaginal vault gapping together with a left fundal uterine rupture. Consequently, the patient was rushed to the operating room for an urgent exploratory laparotomy. The rupture sites were identified and repaired while a large broad ligament hematoma on the same side was explored and hemostasis secured with ipsilateral uterine artery ligation of the fundal and cervical branches. The postoperative course was smooth and the patient left the hospital on the 5th day postpartum. Conclusion: Cases of unscarred uterine rupture are limited. One of the most frequent risk factor is the injudicious use of Misoprostol for labor induction. Sudden arrest of progress of labor or failure to descend might mask uterine rupture. We recommend that all birth attendants be familiar with the guidelines issued by FIGO, ACOG and other societies for the safe use of these potent uterotonics.

Comparison between Sublingual and Vaginal Misoprostol for Induction of Labour in Primigravida

Aims: To compare the outcome and side effects of administration of sublingual misoprostol with vaginal misoprostol for induction of labour and cervical ripening.&#x0D; Methods: It was a hospital based comparative study which was carried out in 120 patients in each group of sublingual and vaginal route of misoprostol induction from August 2016 to February 2017 at Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu. Patients with Bishops score &lt;6 were subjected for Misoprostol 25 μg (for maximum 2 doses) 6 hours apart. Results were analyzed using SPSS 21 taking p-value &lt;0.05 as statistically significant.&#x0D; Results: The mean change in Bishops score after 6 hours of misoprostol was statistically signifi cantly (p=0.001) in sublingual group in comparison to vaginal group. The diff erence in augmentation rate was not statistically signifi cant (p= 0.811). The mean time interval from drug administration to delivery was almost similar in both groups. The indications for cesarean section were similar in both the groups, the most common being fetal distress, (67.33% in sublingual and 58.065% in vaginal group). In terms of maternal and neonatal outcome there was no difference.&#x0D; Conclusions: Sublingual route results in significant changes of Bishop’s score as compared to vaginal route. It was also significantly better in terms of fetal outcome. However, both routes appeared similar in terms of maternal outcome.

LABOUR INDUCTION;

Objective: To compare the efficacy of misoprostol 50ug (sublingual) incomparison with oxytocin infusion than for induction of labour in cases of PROM (prematurerupture of membrane at term). Design: Prospective randomized study. Setting: Mujahid TrustHospital, Faisalabad. Duration: Conducted from Dec 2006 to April 2008. Methods: Womenwere randomized to receive either 50 microgram of sublingual misoprostol every 4 hours withRinger’s lactate solution or oxytocin infusion 10 lU in one litre of Lactated Ringer’s solution witha sublingual placebo. Main outcome measures: The number of women delivering vaginallywithin 24 hours of labour induction. Results: Fifty two women (83%) in misoprostol group and48 (77 %&gt;) in oxytocin group delivered vaginally within 24 hours [relative risk (RR)1.1. However,the induction to vaginal delivery was significantly shorter in the misoprostol group 15+3.7 hourscompared with the oxytocin group 18+4.1. The incidence of tachysystole was more than threefolds higher in misoprostol than in the oxytocin group (14%) versus 4.3%) RR3.3) but this wasnot statistically significant. There was no significant difference in the incidence of hypertonusor hyperstimulation syndrome, mode of delivery intervention for fetal distress or neonataloutcomes between the two groups. Conclusions: The group of women received misoprostolfor labour induction were found more successful in achieving vaginal delivery in comparativelyshorter time and more acceptable to patients. Further studies on safety with large numbers ofwomen need to be conducted before routine use.

A Comparative Study of Buccal Misoprostol Vs Oral Misoprostol for Induction of Labour in Prelabour Rupture of Membranes

A Comparative Study of Buccal Misoprostol Vs Oral Misoprostol for Induction of Labour in Prelabour Rupture of Membranes

Efficacy and safety of misoprostol vaginal insert vs. oral misoprostol for induction of labor

Objectives To compare the oral application form of misoprostol with the misoprostol vaginal insert (MVI) in a Swiss cohort with special regards to the efficacy and safety. Methods We performed a retrospective case series including a historical group induced with oral misoprostol (MO, n=101) and an MVI group (n=101). The primary outcome was time to delivery. Secondary outcomes were mode of delivery, occurrence of tachysystole, use of analgesia and neonatal adverse outcome. Results A total of 202 women were included in the analysis (101 in the MVI as well as in the MO group). Time from start of induction to delivery was significantly shorter in the MVI group compared to the MO group (15.91 h vs. 37.68 h, P<0.001). Within the first 24 h, 78.2% of the women in the MVI group had given birth compared to 28.7% in the MO group (P<0.001). Tachysystole occurred more often in the MVI group (22.8% vs. 5.0%, P<0.001). Women in the MVI group more often needed opioid analgesia during the induction before onset of active labor (31.7% vs. 2.0%, P<0.001). There was no significant difference between neonatal outcomes in the two groups. Conclusion Time to delivery was significantly shorter in the MVI group with a higher rate of vaginal deliveries within the first 24 h. However, patients needed more opioids for pain relief during induction with MVI. There was no difference in neonatal outcomes.

Oral versus Vaginal Misoprostol for Labour Induction : A Comparative Study

Objective: To compare the efficacy and safety of hourly titrated oralmisoprostol in solution (OMS) with vaginal misoprostol (PV) forlabor induction.Methods: Randomized Controlled Trial (RCT), double blind-add onthe study was conducted from January-November 2016 in deliveryward of Moh. Hoesin general hospital. Women 30 weeks of gestationwith an unfavorable cervix (Bishop score 6) and an indicationfor labor induction were randomly assigned to receive titrated oralor vaginal misoprostol. The OMS group received a basal unit of20 ml misoprostol solution (1 g/ml) every 1 hour for four dosesand then were titrated against individual uterine response. In theabsence of regular uterine contractions, the dose was increased to40 ml hourly for four doses and then 60 ml for four doses. Thevaginal group received 25 g every 4 hours until attaining a morefavorable cervix for three doses. All the subjects received amylumplacebo. In labor within 12 hours was the primary outcome.Results: A total of 30 women were enrolled in this study. One subjectin the OMS group was dropped out due to eclamptic seizure. Theaverage interval from induction until in labour in OMS group was5.753.14 hour and 6.604.46 hour in PV group (p = 0.56). In labourstage was achieved within 12 hours in 14 women (100%) in OMSgroup and 14 women (93.3%) in PV group (p = 1.00). Vaginaldelivery was achieved within 24 hours in 13 women (92.9%) inOMS group and 15 women (100%) in PV group. The incidence ofuterine hyperstimulation/ tachysystolic was 7.1% in OMS groupcompared with 13.3% in PV group. Fetal distress was found only 1case (7.1%) in OMS group. There was no difference in the maternaland neonatal outcome of labor in both the groups.Conclusion: Oral titrated in solution, and vaginal route ofadministration of misoprostol for induction of labour areequally effective and safe.[Indones J Obstet Gynecol 2018; 6-2: 89-97]Keywords: hourly titrated oral misoprostol in solution, oral misoprostol,randomized controlled trial, vaginal misoprostol