[Comparative study of the effect of intravaginal misoprostol at 50 and 100 micrograms in cervical ripening and labor induction].
The objective of this work was to compare the efficacy of 50 and 100 microg of misoprostol administered intravaginally for cervical ripening and labor induction. Ninety-five patients were randomly assigned to receive 50 microg (n=48) or 100 microg (n=47) of misoprostol. The primary measures in this study were cesarean section rate, time from induction to delivery, need for oxytocin use, rate of uterine hyperstimulation and tachysystoles, proportion of fetal distress and neonatal Apgar score. The interval from first dose of prostaglandin to delivery was significantly shorter in the 100 ,g-group (p < 0.05). The use of oxytocin augmentation was significantly higher in the 50 microg-group (64.6% vs. 31.9%). There were 9 cases (18.8%) of tachysystole in the 50-microg group and 12 cases (25.5%) in the 100 microg-group (p NS). The cesarean section rate was double in the 100 microg-group and the difference was statically significant (p < 0.05). There was no report of uterine rupture. It can be concluded that 50 microg of misoprostol applied in the posterior vaginal fornix every 4 hours is an effective dosage for labor induction and has less adverse effects and complications than the 100 microg dose.
Servicio de Obstetricia y Ginecología, Maternidad Dr. Nerio Belloso, Hospital Central Dr. Urquinaona, Maracaibo, Venezuela. sippenbauch@medscape.com
Eduardo
E
Reyna-Villasmil
Mery
M
Guerra-Velásquez
Marielys
M
Torres-Montilla
Nadia
N
Reyna-Villasmil
Jorly
J
Mejia-Montilla
Nelida
N
Labarca-Vincero
D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D020070:Cervical Ripening / Q000187:drug effects*; D002585:Cesarean Section / Q000706:statistics & numerical data; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D007744:Obstetric Labor Complications; D010120:Oxytocics / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications; D014590:Uterine Contraction / Q000187:drug effects
D010120:Oxytocics; D016595:Misoprostol