Safety Of Oral Misoprostol Research Articles

Choosing The Right Method For Labour Induction: Misoprostol Alone Versus Misoprostol With Foleys Catheter

Background The aim of the retrospective study is to compare effectiveness, safety of oral misoprostol and Foley’s catheter for labour induction with misoprostol. The efficacy is measured by induction to delivery interval, the total number of normal vaginal spontaneous delivery within 24 hours without any complications. The two methods of induction were compared. As there is no ideal method of induction of labour, several methods and a combination method with Foley’s catheter and misoprostol was used to find the advantage of both methods. Materials and Methods: This retrospective study was conducted among the 400 patients of which 200 patients who had oral misoprostol alone and the rest 200 patients who had Foley’s catheter with misoprostol over the period of four months from 2024 May to August. Inclusion criteria consisted of singleton pregnancy greater than or equal to 37 weeks with intact membrane, cephalic presentation,bishops score less than or equal to 4. The exclusion criteria comprised of previous LSCS or uterine surgery, rupture of membrane. Results: The results were analyzed. The comparison of the maternal effects and also the neonatal outcome were studied in each group. We came to a conclusion that oral misoprfostol alone with Foley’s catheter is a better method for labour induction. Conclusion: The synergetic action of Foley’s catheter and misoprostol is remarkable. It is economical and preferable in developing countries.

Choosing The Right Method For Labour Induction: Misoprostol Alone Versus Misoprostol With Foleys Catheter

Background The aim of the retrospective study is to compare effectiveness, safety of oral misoprostol and Foley’s catheter for labour induction with misoprostol. The efficacy is measured by induction to delivery interval, the total number of normal vaginal spontaneous delivery within 24 hours without any complications. The two methods of induction were compared. As there is no ideal method of induction of labour, several methods and a combination method with Foley’s catheter and misoprostol was used to find the advantage of both methods. Materials and Methods: This retrospective study was conducted among the 400 patients of which 200 patients who had oral misoprostol alone and the rest 200 patients who had Foley’s catheter with misoprostol over the period of four months from 2024 May to August. Inclusion criteria consisted of singleton pregnancy greater than or equal to 37 weeks with intact membrane, cephalic presentation,bishops score less than or equal to 4. The exclusion criteria comprised of previous LSCS or uterine surgery, rupture of membrane. Results: The results were analyzed. The comparison of the maternal effects and also the neonatal outcome were studied in each group. We came to a conclusion that oral misoprfostol alone with Foley’s catheter is a better method for labour induction. Conclusion: The synergetic action of Foley’s catheter and misoprostol is remarkable. It is economical and preferable in developing countries.

A Comparative Study of the Efficacy and Safety of Oral Misoprostol, Intravenous Oxytocin, and Intravaginal Dinoprostone for Labor Induction in Pakistani Women.

A frequent medical procedure to accelerate labor is the induction of labor. There are different methods of labor induction, including the use of medications such as misoprostol, oxytocin, and dinoprostone. This research compared the effectiveness and safety of oral misoprostol, intravenous oxytocin, and intravaginal dinoprostone for labor induction in Pakistani women. A study was conducted in the Department of Obstetrics and Gynaecology, Hayatabad Medical Complex-Medical Teaching Institute (MTI) and Lady Reading Hospital-MTI, Peshawar, Pakistan, over two years. It included 378 women between 38 and 42 gestational weeks, divided into three groups of 126 women each. The oral misoprostol group was given a maximum of six doses of a 25 μg oral misoprostol solution (oral misoprostol tablet of 200 μg dissolved in 200 ml) at intervals of two hours. The drip rate for the intravenous oxytocin group ranged from 6 mIU/minute to 37 mIU/minute. The intravaginal dinoprostone group received a controlled-release vaginal insert containing 10mg of intravaginal dinoprostone, which was left in place for 12 hours. More women in the oral misoprostol group (n=94; 74.6%) had successful inductions when compared to the intravaginal dinoprostone (n=83; 65.9%) and intravenous oxytocin (n = 77; 64.71%) groups. Oral misoprostol had the greatest proportion of normal vaginal deliveries (n=62; 65.95%), followed by intravaginal dinoprostone (n=47; 56.63%), and intravenous oxytocin had the lowest rate (n=33; 42.85%). Cesarean section rates were greatest in the intravenous oxytocin group (n=31; 40.26%), followed by the intravaginal dinoprostone group (n=29; 34.94%), and lowest in the oral misoprostol group (n=24; 25.53%). Oral misoprostol induces labor in women safely and effectively, resulting in the lowest percentage of cesarean deliveries and the highest percentage of normal vaginal deliveries, respectively. Intravaginal dinoprostone showed the lowest rate of side effects, followed by oral misoprostol while intravenous oxytocin had the highest rate of side effects.

Efficacy and safety of oral misoprostol vs transvaginal balloon catheter for labor induction: An observational study within the SWEdish Postterm Induction Study (SWEPIS).

Induction of labor is increasing. A common indication for induction of labor is late term and postterm pregnancy at 41 weeks or more. We aimed to evaluate if there are any differences regarding efficacy, safety, and women's childbirth experience between oral misoprostol and transvaginal balloon catheter for cervical ripening in women with a low-risk singleton pregnancy and induction of labor at 41+0 to 42+0 to 1 weeks of gestation. In this observational study, based on data from the Swedish Postterm Induction Study (SWEPIS), a multicenter randomized controlled trial, a total of 1213 women with a low-risk singleton pregnancy at 41 to 42 weeks of gestation were induced with oral misoprostol (n=744) or transvaginal balloon catheter (n=469) at 15 Swedish delivery hospitals. The primary efficacy outcome was vaginal delivery within 24h and primary safety outcomes were neonatal and maternal composite adverse outcomes. Secondary outcomes included time to vaginal delivery and mode of delivery. Women's childbirth experience was assessed with the Childbirth Experience Questionnaire (CEQ 2.0) and visual analog scale. We present crude and adjusted mean differences and relative risks (RR) with 95% CI. Adjustment was performed for a propensity score based on delivery hospital and baseline characteristics including Bishop score. Vaginal delivery within 24h was significantly lower in the misoprostol group compared with the balloon catheter group (46.5% [346/744] vs 62.7% [294/469]; adjusted RR 0.76 95% CI 0.640.89]). Primary neonatal and maternal safety outcomes did not differ between groups (neonatal composite 3.5% [36/744] vs 3.2% [15/469]; adjusted RR 0.77 [95% CI 0.31-1.89]; maternal composite 2.3% [17/744] vs 1.9% [9/469]; adjusted RR 1.70 [95% CI 0.58-4.97]). Adjusted mean time to vaginal delivery was increased by 3.8h (95% CI 1.3-6.2h) in the misoprostol group. Non-operative vaginal delivery and cesarean delivery rates did not differ. Women's childbirth experience was positive overall and similar in both groups. Induction of labor with oral misoprostol compared with a transvaginal balloon catheter was associated with a lower probability of vaginal delivery within 24h and a longer time to vaginal delivery. However, primary safety outcomes, non-operative vaginal delivery, and women's childbirth experience were similar in both groups. Therefore, both methods can be recommended in women with low-risk postdate pregnancies.

ORAL MISOPROSTOL VERSUS INTRAMUSCULAR OXYTOCIN IN THE ACTIVE MANAGEMENT OF THE THIRD STAGE OF LABOUR

Background: The third stage of labor is defined as the time between the delivery of the baby and delivery of the placenta. The third stage of labor is potentially the most dangerous part for the mother. The main risk is the occurrence of postpartum hemorrhage. Objective: To compare the efficacy and safety of oral misoprostol with intramuscular oxytocin in the active management of third stage of labor for the prevention of postpartum hemorrhage. Patient and Methods: The study was conducted in the labor ward of Obstetrics and Gynecology Department at Imbaba General Hospital from September 2018 till September 2019. This study included four hundred healthy pregnant women during the course of normal labor. Patients in this study were randomly divided into two equal groups: Group (I) received 600 mcg Misoprostol orally within 1 minute of delivery of the baby and Group (II) received 10 IU oxytocin intramuscularly within 1 minute of delivery of the baby. We compared the two groups using computer programs to evaluate the safety and efficacy of each drug. The primary outcome measure was postpartum fall in haemoglobin after 8 h of delivery. Secondary outcome measure was duration of third stage of labor, need for an additional uterotonic drug, need for blood transfusion and side effects of both the drugs. Results: There was no significant difference between the two groups regarding the duration of the third stage of labor, the change in hemoglobin and hematocrit levels from before labor to 8 hours postpartum, and the occurrence of complications (the need for more utrotonic drugs and the need for blood transfusion). As regard the duration of third stage of labor, there was a slight advantage for the oxytocin group over the misoprostol group, 4% of cases in oxytocin group have side effects, while 13% of cases in misoprostol group have sides effects in the form of nausea, vomiting, fever, shivering. Conclusions: No major difference in oral misoprostol and intramuscular oxytocin in the management of third stage of labor.

Labor Induction with Oral Misoprostol in Term Pregnancy: A Clinical Trial

Introduction: Induction of labor has become an increasingly utilized obstetric intervention in developed countries. It contributes to reduce the maternal and perinatal morbidity and mortality. Dinoprostone derivatives are often used under cardiotocography. In poor countries, health structures have neither fetal monitoring, nor means of preserving Dinoprostone derivatives. Misoprostol therefore constitutes an alternative. This study seeks to establish the efficacy and safety of oral Misoprostol and to assess maternal and perinatal prognosis in an area with limited resource. Methods: This is a multi-center clinical trial, conducted in 3 hospitals centers in Kisangani, Tshopo Province/Democratic Republic of Congo from December 1, 2020 to May 31, 2021. Our sample was constituted with 68 pregnant women with term pregnancy. Fifty micrograms of Misoprostol was administered orally. The data were collected prospectively, their encoding was carried out on an Excel sheet 2013 and their analysis carried out using the EPI INFO software. Results: The average age of the pregnant women was 23.17 ± 5.76 years. The average parity was 1.02 ± 1.2. The average body mass index (BMI) was 24.98 ± 2.55 Kg/m2. 66 (97.1%) patients had received a maximum of 3 doses of Misoprostol. Out of the 16 parturients who received 3 doses or more, 11 (68.8%) had a BMI ≥ 25. The average duration of labor was 16.03 ± 7.99 hours. 66 (97.1%) pregnant women had delivered vaginally. 57 (83.8%) patients delivered within 24 hours. Out of the 11 patients who delivered after 24 hours, 7 (63.6%) had a BMI ≥ 25. The induction failure rate was 2.9% (2 patients). 2 (2.9%) fetuses had presented pathological modification of fetal heart rate (FHR). 2 (2.9%) patients had undergone cesarean section. Conclusion: Labor induction with oral Misoprostol is effective and associated with low maternal and perinatal morbidity. A BMI ≥ 25 kg/m2 increases the number of doses to be given and the duration of labor.

ORAL MISOPROSTOL VERSUS INTRAMUSCULAR OXYTOCIN IN THE ACTIVE MANAGEMENT OF THE THIRD STAGE OF LABOUR

Background: The third stage of labor is defined as the time between the delivery of the baby and delivery of the placenta. The third stage of labor is potentially the most dangerous part for the mother. The main risk is the occurrence of postpartum hemorrhage. Objective: To compare the efficacy and safety of oral misoprostol with intramuscular oxytocin in the active management of third stage of labor for the prevention of postpartum hemorrhage. Patient and Methods: The study was conducted in the labor ward of Obstetrics and Gynecology Department at Imbaba General Hospital from September 2018 till September 2019. This study included four hundred healthy pregnant women during the course of normal labor. Patients in this study were randomly divided into two equal groups: Group (I) received 600 mcg Misoprostol orally within 1 minute of delivery of the baby and Group (II) received 10 IU oxytocin intramuscularly within 1 minute of delivery of the baby. We compared the two groups using computer programs to evaluate the safety and efficacy of each drug. The primary outcome measure was postpartum fall in haemoglobin after 8 h of delivery. Secondary outcome measure was duration of third stage of labor, need for an additional uterotonic drug, need for blood transfusion and side effects of both the drugs. Results: There was no significant difference between the two groups regarding the duration of the third stage of labor, the change in hemoglobin and hematocrit levels from before labor to 8 hours postpartum, and the occurrence of complications (the need for more utrotonic drugs and the need for blood transfusion). As regard the duration of third stage of labor, there was a slight advantage for the oxytocin group over the misoprostol group, 4% of cases in oxytocin group have side effects, while 13% of cases in misoprostol group have sides effects in the form of nausea, vomiting, fever, shivering. Conclusions: No major difference in oral misoprostol and intramuscular oxytocin in the management of third stage of labor.

Safety and efficacy of different prostaglandins used at term pregnancy for labour induction: a comparative study

BackgroundProstaglandins are commonly used for labour induction in obstetric practice. Given the harsh effects of occupation and siege on provision of health care and on economic conditions, this study was conducted to compare the efficacy and safety of oral misoprostol and vaginal dinoprostone, to find the more appropriate and economic drug for labour induction in the Gaza Strip, occupied Palestinian territory. MethodsIn this case-control study, we screened medical files of 155 women undergoing labour induction at Al-Helal Al-Emirati Hospital, Rafah, in the Gaza Strip. Inclusion criteria were singleton, cephalic presentation, and full-term pregnancies (40 weeks) needing labour induction. Patient files were divided into two groups according to the drug regimen. 76 women received 50 μg oral misoprostol for parity 0–4 or 25 μg for parity 4 or greater, every 6 hours. 79 women received dinoprostone vaginal tablets, with a dose of 3 mg then 1·5 mg for nulliparous women and 1·5 mg for parity 1 or greater, every 8 hours. There were no significant differences between the misoprostol and dinoprostone groups in terms of mean age (25·07 [SD 5·66] vs 27·86 [6·56] years, p=0·34), mean gestational age (279·43 [SD 11·41] vs 285·57 [SD 15·50] days, p=0·81), and mean parity (2·10 [SD 1·97] vs 2·73 [SD 2·64], p=0·05). Outcome measures were induction success, induction–delivery interval, number of used drugs and doses, caesarean section rate, and maternal complications. Data were analysed with SPSS software. We compared outcomes using the Mann–Whitney U-test, student's t-test, or chi squared test. A p value of less than 0·05 was considered significant. The study was approved by the Helsinki Committee, Gaza Strip. FindingsInduction of labour succeeded in 80% (61 of 76) and 78% (62 of 79) cases (p=0·492) in the misoprostol and dinoprostone groups, respectively. There was no significant difference between the misoprostol and dinoprostone groups in the induction–delivery interval (15·2 h vs 16·4 h, p=0·625). The number of doses required was 2·2 and 1·8 in the misoprostol and dinoprostone groups, respectively (p=0·070). The caesarean section rate did not differ significantly between the misoprostol and dinoprostone groups (7·9% [six of 76] vs 10·1% [eight of 79], p=0·369). In addition, complications (mild vaginal bleeding, post-partum haemorrhage, and puerperal fever) also did not differ significantly between the misoprostol and dinoprostone groups (37·7% [23 of 76] vs 33·9% [21 of 79], p=0·430), and all were mild. InterpretationOral misoprostol and dinoprostone vaginal tablets have the same safety and efficacy. Misoprostol is a good alternative for induction of labour. FundingNone.

Effect of oral misoprostol, alone or in combination with aglepristone, on mid-term pregnancy termination in cats.

This study aimed to determine the efficacy and safety of oral misoprostol (MIS) administration in the induction of mid-term pregnancy termination in cats. Twenty-eight cats that were pregnant for 30-40 days were allocated to four groups. The aglepristone (AGL) group (n = 7) received 10 mg/kg SC aglepristone q24h for two consecutive days. In the AGL+MIS group (n = 7), AGL (as administered in the AGL group) and MIS (200 µg/cat PO q12h until the start of abortion) were administered. The MIS200 (n = 7) and MIS400 groups (n = 7) received MIS (200 or 400 µg/cat misoprostol, respectively) alone PO q12h until the start of abortion. Blood samples were collected at the start of treatment (d0), 4 days after the start of treatment (d4) and on the day of complete abortion/end of administration (dA/d7). The efficacy of the treatment was 71.4% in the AGL group, 100% in the AGL+MIS group, 0% in MIS200 group and 57.4% in MIS400 group (P = 0.004). No significance was found in relation to the interval from treatment to the start/end of abortion and the duration of abortion in all groups. The most observed side effect was vomiting in both groups administered MIS, particularly in the MIS400 group (56.7%). Progesterone (P4) concentrations were reduced during the abortion, but not to basal levels, in all groups. P4 concentrations were significantly lower at dA/d7 in the MIS400 group compared with the AGL and AGL+MIS groups (P = 0.002). The results obtained from this study showed that low doses of MIS do not induce abortions in cats but increase the effect of AGL. Although higher doses could terminate pregnancies, this also causes intense unwanted side effects. Therefore, the use of MIS alone as an abortifacient in cats is not recommended. For mid-term pregnancy termination in cats, the combination of misoprostol and aglepristone provides a more effective abortifacient than using either of them alone.

A Comparison of Orally Administered Misoprostol With Vaginally Administered Misoprostol For Cervical Ripening And Labour Induction

Objective: To compare efficacy and safety of oral misoprostol over vaginal misoprostol for labour induction.Materials and Methods: This is a cross sectional interventional hospital based comparative study which was carried in the department of Obstetrics and Gynecology in DMCH from 01.07.2008 to 31.12.2008.Results: Almost equal number of patients delivered vaginally spontaneously in both group, there is no association between route of administration and mode of delivery. Nausea,vomiting occurred more in oral group and uterine hypertonicity more in vaginal group.Conclusion: In this study, 50 patients were randomly selected for oral group and 50 patients for vaginal group. There were no significant differences regarding age, duration of pregnancy, Bishop's score and indication of induction of labour.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 668-672

Comparison of oral misoprostol and oxytocin for labor induction in prelabor rupture of membranes at term

Objective This study aims to compare the efficacy and safety of oral misoprostol with oxytocin infusion for induction of labor in women with prelabor rupture of membranes (PROM) at term. Background PROM at term is one of the most common complications of pregnancy. It is an important cause of perinatal morbidity and mortality, particularly if it is associated with a prolonged latency period from membranes rupture to delivery. Patients and methods This prospective randomized study included 100 pregnant women admitted to the Department of Obstetrics and Gynecology at El-Mahalla General Hospital presenting with PROM at term. The women were assigned randomly to one of the two equal groups (groups A or B): group A, which received 100 mg oral misoprostol every 4 h for a maximum of three doses, and group B, which received an intravenous infusion of oxytocin starting with a dose of 4 mU/min with an incremental increase of 4 mU/min every 30 min until a maximum dose of 32 mU/min. The primary outcome variable was time from induction to vaginal delivery. The secondary outcomes were mode of delivery, maternal, and neonatal outcomes. Results The study showed that the time intervals from induction to delivery were significantly shorter in the misoprostol group than in the oxytocin group (6.59 ± 1.91 and 9.30 ± 2.58 h, respectively; P Conclusion Oral misoprostol at a dose of 100 mg every 4 h was not only as successful as oxytocin for labor induction in women presenting with PROM at term but also reduced the duration of labor in nulliparous women. Oral misoprostol was safe in terms of maternal and neonatal outcomes.

Role of Oral Misoprostol 600 mcg versus Inj. Syntometrinein the Active Management of Third Stage of Labour

Postpartum haemorrhage is the leading cause of direct maternal death in developing countries. The incidence of PPH may vary from less than 5% to more than 10%. About 30% of maternal deaths in India occur due to massive haemorrhage. Normal blood loss in a vaginal delivery may exceed 500 ml and can range from 500 to 1000 ml. A decline in hematocrit is a more reliable estimation of blood loss. Active management had definitely reduced third stage blood loss. World Health Organisation (WHO) recommends Intra muscular oxytocin in the third stage oflabour. Misoprostol PGE1 is a potent uterotonic agent. Ergometrine is also an effective oxytocic. This study has been conducted to compare the efficacy and safety of oral misoprostol 600 mcg with parenteral syntometrine in the active management of third stage of labour in 100 pregnant women of low risk pregnancies by objective assessment of the difference in pre- and post-delivery haemoglobin values. This study concludes that misoprostol has the potential of an effective, stable oral oxytocic with rapid onset of action. Though this study was limited to low risk patients, misoprostol has scope for use even in high risk patients of bronchial asthma, gestational hypertension, pre-eclampsia and Rhesus (Rh) negative groups where syntometrine is contraindicated. Thus, misoprostol may be used as an alternative to IM syntometrine in the active treatment of third stage of labour.

Induction of labor in twin pregnancies with oral misoprostol versus vaginal dinoprostone – is it effective and safe?

Objective: To compare the effectiveness and safety of oral misoprostol versus vaginal dinoprostone for the induction of labor in twin pregnancies.Methods: All twin pregnancies ≥ 34 weeks 0 days that were induced with either misoprostol or dinoprostone in St. Hedwig Hospital between 2002 and 2013 were included in this retrospective study. Length of induction, mode of delivery, maternal and neonatal outcomes were compared between the two groups.Results: After identifying 186 twin mothers matching the inclusion criteria, 154 women were induced with misoprostol (group A) and 32 with dinoprostone (group B). There were no differences in demographic data between the groups. Rates of successful vaginal delivery (53.9% versus 56.3%) and length of induction to delivery (30.2 h versus 26.9 h) were also similar. There were slightly higher rates of postpartum hemorrhage in group B (16.6% versus 10.8%), but without reaching statistical significance. Neonatal outcomes regarding umbilical artery pH <7.20 and one minute Apgar also were without significant differences.Conclusions: Study data indicate that oral misoprostol and vaginal dinoprostone are similarly effective and safe for the induction of labor in twin gestations. Further trials with larger series are needed to confirm these results.

Oral misoprostol versus intracervical prostaglandin E2 gel for active management of premature rupture of membranes at term

Objective To compare the efficacy and safety of oral misoprostol with intracervical prostaglandin E2 (PGE2) gel for the active management of premature rupture of membranes (PROM) at term. Methods Women with pregnancies between 37 and 42 weeks presenting with PROM at term and a Bishop score of 5 or less were randomly assigned to receive either a 4-hourly oral dose of 50 µg of misoprostol up to a maximum of 3 doses or 2 applications of intracervical PGE2 gel at a 6-hour interval. Oxytocin was given if labor had not started after 12 hours. Results Twenty women in the misoprostol group (n = 31) delivered within 12 hours compared with 5 in the PGE2 group (n = 30) ( P < 0.001). The induction-to-delivery interval in the misoprostol group was shorter than in the PGE2 gel group (615 min vs 1070 min; P < 0.001). The mode of delivery was comparable between the 2 groups ( P = 0.821). Abnormalities in uterine contractions and neonatal outcomes were also comparable. The requirement for oxytocin was lower and patient satisfaction was better in the misoprostol group. Conclusion Oral misoprostol is a safe and efficacious alternative to intracervical PGE2 gel in the active management of PROM at term.

Oral Misoprostol: A Safe and Effective Alternative in Comparison to Conventional Uterotonic Agents in the Active Management of Third Stage of Labor

ABSTRACT Objective To determine the efficacy and safety of oral misoprostol with intravenous oxytocin and syntometrine in the active management of third stage of labor. Methodology 325 women were randomly allocated by convenient sampling to receive either 10 IU of intravenous oxytocin or 10 IU of oxytocin with 0.2 mg of Methergine (syntometrine) or 400 mcg of oral misoprostol at the delivery of anterior shoulder. Main outcome measures were estimation of blood loss &gt; 500 ml, drop in hemoglobin/hematocrit levels and adverse effects of drugs. Results Estimated blood loss was significantly higher in group misoprostol group (p = 0.016) but comparable to oxytocin group (p = 0.40). Drop in hemoglobin level was comparable in all the three groups (p = 0.106). Drop in hematocrit value was significant for misoprostol and syntometrine (p = 0.022) but comparable to oxytocin. Nausea and vomiting was common in oxytocin and syntometrine group whereas fever and shivering was the leading adverse effect in misoprostol group. Conclusion Misoprostol is an effective and safe alternative to intravenous uterotonic agents in the active management of third stage of labor both at tertiary and community level.

Prospektiv randomisierte Studie zum Vergleich von Misoprostol oral mit Dinoproston vaginal bei der Geburtseinleitung am Termin

It was the objective of this study to compare the efficacy and safety of oral misoprostol with those of vaginal dinoprostone for the induction of labour at term. Between 2003 and 2006 224 pregnant women were included in our prospective randomised clinical trial. All of them were admitted for induction of labor at term. Half of the patients received oral misoprostol, initially at a test dose of 25 microg, followed by 50 microg and 100 microg every 4 hours. The control group received 3 mg vaginal dinoprostone every 6 hours. Primary endpoints were time interval until delivery and mode of delivery as well as maternal and neonatal outcome, secondary endpoints were side effects and costs. In the dinoprostone group, the median time interval until delivery was 17.6 hours compared to 24.1 hours in the misoprostol group. Without the test dose, the difference was no longer significant. After dinoprostone induction, more patients had a vaginal delivery within 24 hours (n=60, 53.6%, vs. n=46, 41.1%). The frequencies of spontaneous deliveries and emergency Caesarean sections did not differ between the groups. The rate of vacuum extractions was higher in the misoprostol group (23 vs. 11, i. e. 20.5 vs. 9.8%, p<0.05). With regard to side effects there was no significant difference. No case of hyperstimulation was documented. Oral misoprostol is effective and safe for induction of labour at term. In addition, it is much cheaper and independent of storage conditions. At the doses and with the administration intervals used in this study, dinoprostone was slightly more effective than misoprostol.

A Randomized Controlled Trial of Misoprostol and Oxytocin in the Management of Third Stage of Labor

The study was conducted to compare the effectiveness and safety of oral misoprostol with intramuscular oxytocin in the management of third stage of labor. One hundred patients were selected randomly who are expected to have vaginal delivery. Fifty patients received oral misoprostol 600 microgram and other fifty patients received oxytocin 10 IU intramuscularly after the birth of the baby. There were no significant differences between the prevalence of postpartum hemorrhage, duration of third stage of labor, additional oxytocin requirement, manual removal of placenta and blood transfusion. About the side-effects, shivering and fever were significantly higher in misoprostol group (p&lt;0.001) and (p&lt;0.003) respectively. But there were no significant differences in other sideeffects. Oral misoprostol can be used instead of intramuscular oxytocin in the management of third stage of labor, to prevent postpartum hemorrhage, in developing countries, especially as it is administered orally and thermo stable in tropical climate. Key words: Misoprostol; Oxytocin; Postpartum haemorrhage DOI: 10.3329/bjpp.v24i1.5732Bangladesh J Physiol Pharmacol 2008; 24(1&amp;2) : 14-16