title: Use of misoprostol for cervical ripening.
abstract: BACKGROUND
  Misoprostol, the prostaglandin E1 analog, is increasingly used for cervical ripening and induction of labor. We evaluated our experience with misoprostol in an open-label setting.
  
  
  METHODS
  Patients were selected for cervical ripening based on clinical profile. At 3 cm cervical dilation, misoprostol was discontinued and other means of labor augmentation were used. Over 13 months, 470 inductions of labor occurred, and 455 charts were available; 254 patients (56%) received misoprostol for cervical ripening, and 144 (32%) received dinoprostone (prostaglandin E2).
  
  
  RESULTS
  With misoprostol, mean time from beginning of contractions until delivery was 7 hours, 30 minutes; vaginal birth occurred in 85% of cases, and spontaneous labor occurred in 38%. Hyperstimulation occurred in 4 cases (1.6%) and precipitate labor in 7 (3%). All infants were discharged in excellent condition; one had a 5-minute Apgar score <7, and 33 (13%) had meconium, none with aspiration. Twenty-three patients who had had a previous cesarean section received misoprostol and delivered vaginally.
  
  
  CONCLUSIONS
  Misoprostol was found to be a safe and effective agent for cervical ripening as part of labor induction.
authors.affiliation: Sacred Heart Medical Center, Eugene, Ore, USA.
authors.forename: V L
authors.initials: VL
authors.lastname: Katz
authors.forename: R M
authors.initials: RM
authors.lastname: Farmer
authors.forename: C A
authors.initials: CA
authors.lastname: Dean
authors.forename: M E
authors.initials: ME
authors.lastname: Carpenter
mesh_terms: D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D020070:Cervical Ripening / Q000187:drug effects*; D002584:Cervix Uteri / Q000187:drug effects; D036861:Delivery, Obstetric; D015232:Dinoprostone / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005316:Fetal Distress / Q000139:chemically induced; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000379:methods; D007743:Labor, Obstetric / Q000187:drug effects; D008470:Meconium; D016595:Misoprostol / Q000009:adverse effects / Q000627:therapeutic use*; D010120:Oxytocics / Q000009:adverse effects / Q000627:therapeutic use*; D010121:Oxytocin / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012449:Safety; D013997:Time Factors; D016896:Treatment Outcome; D014590:Uterine Contraction / Q000187:drug effects; D016064:Vaginal Birth after Cesarean
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin; D015232:Dinoprostone