title: Comparison of 25 and 50 microg vaginally administered misoprostol for preinduction of cervical ripening and labor induction.
abstract: Our purpose was to compare the efficacy of 25 microg and 50 microg intravaginally administered misoprostol tablets for cervical ripening and labor induction. Either 25-microg (n: 58) or 50-microg (n: 56) misoprostol tablets were randomly administered intravaginally to 114 subjects with an unripe cervix for labor induction. The physician was blinded to the medication. Intravaginal misoprostol was given every 4 h until the onset of labor. The mean Bishop score before misoprostol administration was 2.1 +/- 1.6 in the 25-microg group and 2.0 +/- 1.4 in the 50-microg group (p > 0.05). With the 25-microg dose the time until delivery was significantly longer (991.2 +/- 514.4 min vs. 703.12 +/- 432.6 min in the 50-microg group). The use of oxytocin augmentation was significantly higher in the 25-microg group (63.8%) than the 50-microg group (32.1%; p < 0.05). The proportions of patients with tachysystoles and hypersystoles were not significantly different between the two groups (19 and 6.9%, respectively, in the 25-microg group and 25 and 17.8%, respectively, in 50-microg group; p > 0.05). Overall, in the 25-microg group more women achieved vaginal delivery (79.3 vs. 60.7%; p < 0.05). The rate of cesarean sections due to non-reassuring fetal status was higher in the 50-microg misoprostol group (28.6 vs. 10.3%; p < 0.05). The number of neonates with a low 1-min Apgar score (<7) was significantly higher in the 50-microg misoprostol group (26.8 vs. 8.6%; p < 0.05), but 5-min Apgar scores and umbilical artery blood gas values at the time of delivery were not significantly different between the groups (p > 0.05). One patient in the 25-microg group suffered a ruptured uterus. Intravaginal administration of 25 microg of misoprostol is a clinically effective labor induction regimen and has the least adverse effects and complications.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Istanbul, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Has
authors.forename: Cem
authors.initials: C
authors.lastname: Batukan
authors.forename: Hayri
authors.initials: H
authors.lastname: Ermis
authors.forename: Erdal
authors.initials: E
authors.lastname: Cevher
authors.forename: Ahmet
authors.initials: A
authors.lastname: Araman
authors.forename: Gökhan
authors.initials: G
authors.lastname: Kiliç
authors.forename: Lem'i
authors.initials: L
authors.lastname: Ibrahimoğlu
mesh_terms: D000282:Administration, Intravaginal; D020070:Cervical Ripening / Q000187:drug effects; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013607:Tablets
chemical_list: D010120:Oxytocics; D013607:Tablets; D016595:Misoprostol