Intravaginal misoprostol vs. expectant management in premature rupture of membranes with low Bishop scores at term.
OBJECTIVE
To evaluate the efficacy of vaginal misoprostol for cervical ripening and labor induction in premature rupture of membranes (PROM) cases with low Bishop scores at term.


METHODS
Sixty-two PROM cases who fulfilled the criteria of 36 weeks of completed gestation, not in active labor, singleton pregnancy with vertex presentation, normal fetal heart rate reactivity, amniotic fluid index >5 cm and Bishop score <5, consented to participate in the study. Thirty-one of the cases were included in study group and a 50-microg misoprostol tablet was placed in the posterior vaginal fornix. Another 31 cases were included in control group and managed expectantly. Treatment success was defined as an interval from membrane rupture to delivery of <24 h.


RESULTS
The mean admittance-delivery interval was significantly shorter in the study group (8.68+/-4.40 h) compared with the control group (26.22+/-18.98 h, P=0.001) and the mean interval from membrane rupture to delivery were also significantly shorter in the study group (19.37+/-7.20 h) than the control group (33.05+/-20.85 h, P=0.001). Oxytocin necessity was significantly lower in the study group than the control group (45.2% vs. 100%, P=0.00051). Tachysystole occurred more frequently in the study group (8 cases, 25.8% vs. 2 cases, 6.5%, P=0.038). There were no difference between two groups with regard to birth weights, 1- and 5-min Apgar scores and the need for neonatal intensive care unit.


CONCLUSIONS
It is effective, safe and economic to use misoprostol vaginally in PROM cases with low Bishop scores at term.
Ozden
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S
Zeynep Kamil Women and Children Education and Research Hospital, Istanbul, Turkey. drselcukozden@yahoo.com
Delikara
M N
MN
Avci
A
A
Fiçicioglu
C
C
D000282:Administration, Intravaginal; D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy*; D006801:Humans; D007747:Labor Stage, First / Q000187:drug effects; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third
D010120:Oxytocics; D016595:Misoprostol