Role of titrated low dose oral misoprostol solution in induction of labour

Background: Induction of labour is a therapeutic option when the benefits of delivery outweigh risks of continuing pregnancy. There are several agents for induction of labour to achieve better outcome of labour. Acceptable methods for induction are oxytocin infusion, dinoprostone gel, misoprostol and mechanical cervical dilators. Prostaglandins are the preferred choice in unripened cervix. To study the neonatal outcome in induction of labour with low dose oral misoprostol compared with intracervical dinoprostone gel and also to assess occurrence of meconium staining liquor.Methods: One hundred women with single live fetus, term gestation, cephalic presentation, reactive fetal heart pattern and Bishops score <6 were included in the study. They were randomized to receive either 6 doses of 25ug oral misoprostol every 3rd hourly or 0.5ug intracervical dinoprostone every 6th hourly for a maximum of 3 doses. Oxytocin was administered. Fetal outcome was assessed in terms of APGAR score, meconium staining and need for NICU.Results: Meconium stained amniotic fluid was high in misoprostol group (16%) compared to dinoprostone group (8%). NICU admissions were seen in 7 neonates in both groups.Conclusions: Low dose oral misoprostol is a safe method of labour induction. APGAR and NICU admission rates were comparable in both groups. Meconium staining was more in misoprostol group compared to dinoprostone group.

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Low-dose oral misoprostol for induction of labour

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd014484 ◽

2021 ◽

Vol 2021 (6) ◽

Author(s):

Robbie S Kerr ◽

Nimisha Kumar ◽

Myfanwy J Williams ◽

Anna Cuthbert ◽

Nasreen Aflaifel ◽

...

Keyword(s):

Low Dose ◽

Induction Of Labour ◽

Oral Misoprostol ◽

Dose Oral

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Randomized control trial of low dose oral misoprostol compared with intracervical dinoprostone gel for cervical ripening

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175510 ◽

2017 ◽

Vol 7 (1) ◽

pp. 104

Author(s):

Savithri D. R. ◽

Prashanthi Chennupalli ◽

Suvarna R. ◽

Akshatha S.

Keyword(s):

Low Dose ◽

Therapeutic Option ◽

Caesarean Section Rate ◽

Induction Of Labour ◽

Cervical Ripening ◽

P Value ◽

Maternal Complications ◽

Oral Misoprostol ◽

Misoprostol Group ◽

Dose Oral

Background: Induction of labour is a therapeutic option when the benefits of delivery outweigh risks of continuing pregnancy. There are several agents for induction of labour to achieve better outcome of labour. Acceptable methods for induction are oxytocin infusion, dinoprostone gel, misoprostol and mechanical cervical dilators. Prostaglandins are the preferred choice in unripened cervix. Objective of this study was to compare efficacy, safety of low dose oral misoprostol compared with intracervical dinoprostone gel for cervical ripening.Methods: One hundred women with single live fetus, term gestation, cephalic presentation, reactive fetal heart pattern and Bishops score <6 were included in the study. They were randomized to receive either 6 doses of 25ug oral misoprostol every 3rd hourly or 0.5ug intracervical dinoprostone every 6th hourly for a maximum of 3 doses.Results: Bishops score improvement after 6,12,18 hours in both the groups was statistically insignificant. Induction delivery interval was11.96±5.88 for misoprostol and 10.95±4.58 in dinoprostone group with P value 0.341 which was statistically insignificant. Need for oxytocin augmentation was less (18%) in misoprostol group as compared to dinoprostone group (44%). Caesarean section rate was slightly higher in misoprostol group (26% vs 24%). Meconium stained amniotic fluid was high in misoprostol group (16%) compared to dinoprostone group (8%). Maternal complications were minimal and neonatal outcome was good in both the groups.Conclusions: Compared to dinoprostone; misoprostol is easy to store, cost effective, stable at room temperature, can be easily administered and had better patient compliance and acceptability. It was found to be a better cervical ripening agent with similar maternal and fetal safety profile.

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Low-Dose Oral Misoprostol for Induction of Labor

Obstetrics and Gynecology ◽

10.1097/aog.0b013e3181945859 ◽

2009 ◽

Vol 113 (2, Part 1) ◽

pp. 374-383 ◽

Cited By ~ 32

Author(s):

Timothy W. Kundodyiwa ◽

Zarko Alfirevic ◽

Andrew D. Weeks

Keyword(s):

Low Dose ◽

Induction Of Labor ◽

Oral Misoprostol ◽

Dose Oral

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Women’s Experiences of Induction of Labour With Low-dose Misoprostol Oral Tablets Compared With Slow-release Vaginal Insert. A Prospective Cohort Study Based on Questionnaires.

10.21203/rs.3.rs-127692/v1 ◽

2020 ◽

Author(s):

Karen Hell Hansen ◽

Maria Jeppegaard ◽

Axelina Eriksson ◽

Sarah C. B. Jeppesen ◽

Lone Krebs

Keyword(s):

Low Dose ◽

Slow Release ◽

Induction Of Labour ◽

Continuous Variables ◽

Chi Square ◽

Women’S Experiences ◽

Women's Experiences ◽

Validated Questionnaire ◽

Nulliparous Women ◽

Oral Misoprostol

Abstract Background: The aim of this study was to compare nulliparous women’s experiences of induction of labour with two different regimens of misoprostol.Methods: In two different hospitals, nulliparous women undergoing medical induction of labour were asked to complete a questionnaire after delivery. We adapted a validated questionnaire regarding mood and feelings during induction of labour, experience of labour and experience of induction.The questionnaire was completed by 123 (42.7%) of 288 eligible women; 57 (46.3%) had been allocated to oral misoprostol and 66 (53.7%) to slow-release vaginal insert. An independent-samples T-test was used for comparison of parametric continuous variables and a Pearson chi-square test was used for categorical data.Results: Women induced with oral misoprostol experienced a more painful induction of labour (p=0.019) and described feeling the length of stay at hospital as too long (p=0.028). The overall experience of giving birth after induction of labour was reported as “good” among 87.8% of women induced with oral misoprostol compared to 72.7% of women induced with slow-release misoprostol vaginal insert (p=0.039). Conclusions: Induction with low-dose oral misoprostol in nulliparous women is associated with experience of more pain and longer duration but overall a more positive experience of labour compared with induction with slow-release misoprostol vaginal insert.Trial registration: Clinicaltrials.gov ID: NCT02693587 on February 262,016.EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered.

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