Use of misoprostol for cervical ripening.
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.
Katz
V L
VL
Sacred Heart Medical Center, Eugene, Ore, USA.
Farmer
R M
RM
Dean
C A
CA
Carpenter
M E
ME
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
D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin; D015232:Dinoprostone