title: Prediction of adverse outcome associated with vaginal misoprostol for labor induction.
abstract: OBJECTIVE
  To identify predictors of adverse outcome in pregnant women at term receiving 50 microg of intravaginal misoprostol for labor induction.
  
  
  METHODS
  A prospective observational study was conducted of 720 pregnant women at term with an unfavorable cervix and a medical or obstetric indication for labor induction. All patients received 50 microg of intravaginal misoprostol every 4h up to three doses. The primary outcome measure was "adverse outcome" defined as: neonatal death, fetal acidemia and emergent cesarean delivery performed for non-reassuring fetal heart rate tracings. A stepwise logistic regression analysis was used to identify predictors of adverse outcome.
  
  
  RESULTS
  Tachysystole (frequent uterine contractions) (odds ratio (OR), 3.7; 95% confidence interval (CI), 1.2-10.8) and fetal tachycardia (OR, 4.8; 95% CI, 1.4-16.2) were determined as significant predictors of adverse outcome. The specificity of the model was 94.2%, whereas the sensitivity was 20.4%.
  
  
  CONCLUSIONS
  In the absence of tachysystole and fetal tachycardia, an uneventful delivery might be expected for women receiving 50 microg of intravaginal misoprostol.
authors.affiliation: SSK Maternity and Women's Health Teaching Hospital, Ankara, Turkey. mmmeydanli@superonline.com
authors.forename: M
authors.initials: M
authors.lastname: Mutlu Meydanli
authors.forename: Eray
authors.initials: E
authors.lastname: Caliskan
authors.forename: Ali
authors.initials: A
authors.lastname: Haberal
mesh_terms: D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D005260:Female; D005312:Fetal Blood; D005315:Fetal Diseases / Q000453:epidemiology; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007226:Infant Mortality; D007231:Infant, Newborn; D007751:Labor, Induced / Q000379:methods*; D016015:Logistic Models; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects*; D011247:Pregnancy; D011446:Prospective Studies; D013610:Tachycardia / Q000453:epidemiology; D014590:Uterine Contraction
chemical_list: D016595:Misoprostol