Misoprostol in labour induction of term pregnancy: a meta-analysis.
OBJECTIVE
To evaluate the efficacy and safety of misoprostol in term labour induction.


METHODS
Data from published English and Chinese literatures about misoprostol in term labour induction were identified from Medline and CBMdisk (using the search terms "misoprostol" and "labour induction") before 2001; hand searches of reference lists of original studies and reviews (including meta-analyses) and contact with investigators in this field before 2001.


METHODS
Studies were included if they had data on misoprostol and labour induction. Altogether 623 articles were found and 124 were admitted, including 19,287 cases.


METHODS
Data were collected on efficacy and incidence of side-effects of misoprostol and oxytocin. Data were checked for consistency within the published articles and converted into a standard format for incorporation into a central database.


RESULTS
The average successful induction rate, rates of caesarean section; incidence of tachysystole, hypertonus of uterus and precipitous labour, and rates of meconium stained amniotic fluid between the misoprostol and oxytocin groups were significantly different (P < 0.05). There were no significant differences between the two groups concerning the average interval from the administration of misoprostol and oxytocin to the onset of labour, duration of the total stage of labour, incidence rate of foetal distress, neonatal asphyxia (1-minute Apgar score < and= 7), postpartum haemorrhage or amount of blood loss in postpartum.


CONCLUSIONS
Misoprostol is a superior agent over oxytocin on the induction of term labour, but its application might increase the risk of precipitous labour, abnormal uterine contractions or meconium stained amniotic fluid. Therefore, the dosages and regimens of the agent need further investigation.
Li
Xiao-mao
XM
Department of Obstetrics and Gynaecology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. tigerlee777@163.net
Wan
Jing
J
Xu
Cheng-fang
CF
Zhang
Yu
Y
Fang
Li
L
Shi
Zhong-jie
ZJ
Li
Kai
K
D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000009:adverse effects; D010120:Oxytocics / Q000009:adverse effects; D010121:Oxytocin; D011247:Pregnancy; D012449:Safety
D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin