title: Outpatient misoprostol cervical ripening without subsequent induction of labor to prevent post-term pregnancy.
abstract: BACKGROUND
  Interventions that may help shorten the duration of pregnancy in an African setting where facilities for fetal monitoring in post-term pregnancy are limited, and induction is not without its hazards, are needed.
  
  
  OBJECTIVE
  To determine whether outpatient administration of intravaginal misoprostol safely decreases the interval to delivery in postdate pregnancies.
  
  
  METHODS
  Open randomized controlled trial.
  
  
  METHODS
  Zonal district hospitals, Kwale, Southern Nigeria (August 2000 to October 2001).
  
  
  METHODS
  Seventy-seven women were randomized at 40 weeks gestation to receive either 25 microg misoprostol intravaginally (38) or gentle cervical assessment only (39) on an outpatient basis. Subjects were then allowed to go into spontaneous labor unless an indication for induction developed.
  
  
  METHODS
  Interval to delivery, duration of labor, and incidence of side-effects.
  
  
  RESULTS
  Misoprostol was associated with significant decrease in mean time to delivery (4.5 +/- 4.1 versus 7.4 +/- 5.2 days; P = 0.008), earlier gestational age at delivery (40.6 +/- 0.6 versus 41.4 +/- 0.05 weeks; P < 0.001) and shorter duration of active labor (6.1 +/- 4.0 versus 8.2 +/- 5.3 h; P = 0.028), without any significant increase in fetal distress, low Apgar score at delivery or other side-effects.
  
  
  CONCLUSIONS
  Outpatient administration of low-dose misoprostol can safely shorten the length of gestation in postdate pregnancies.
authors.affiliation: Maternity Unit, Zonal General Hospital, Kwale, Nigeria. oborovo@hotmail.com
authors.forename: Victor O
authors.initials: VO
authors.lastname: Oboro
authors.forename: Tabs O
authors.initials: TO
authors.lastname: Tabowei
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D000553:Ambulatory Care; D020070:Cervical Ripening / Q000187:drug effects*; D016009:Chi-Square Distribution; D005260:Female; D005865:Gestational Age; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011273:Pregnancy, Prolonged / Q000187:drug effects*; D018709:Statistics, Nonparametric
chemical_list: D010120:Oxytocics; D016595:Misoprostol