Pilot study of labor induction with titrated oral misoprostol.
OBJECTIVE
To evaluate the safety and efficacy of titrated oral misoprostol for labor induction at term.


METHODS
Seventy-seven pregnant women (37 nullipara and 40 multipara), with medical or obstetric indications for labor induction after 37 weeks of gestation and unfavorable cervices (Bishop's score < 7), were induced according to the principles of titrated oral doses of misoprostol against uterine response. Our primary outcome measurements were the percentage of patients who had a vaginal delivery within 24 hours of induction and the interval from induction to vaginal delivery. Secondary measurements included oxytocin requirement, total misoprostol dosage, number of cesarean deliveries, induction failure, uterine hyperstimulation rates and neonatal outcomes.


RESULTS
Seventy-five women (97.4%) experienced active labor within 24 hours, with 72 (93.5%) completing vaginal delivery within 24 hours. The mean interval from induction to vaginal delivery for all the women was 9.7 hours, with a 2.3-hour active phase. The mean misoprostol dosage was 206 microg, with eight women (10.4%) requiring oxytocin augmentation. There was no uterine hyperstimulation or induction failure, except for seven cases of uterine tachysystole (9.1%).


CONCLUSIONS
Titrated oral misoprostol is a safe and effective method of labor induction because the dosage can be adjusted according to individual response.
Cheng
Shi-Yann
SY
Department of Obstetrics and Gynecology, China Medical University Peikang Hospital, Yun Lin, Taiwan. shiyann@ms18.url.com.tw
Chen
Tai-Chang
TC
D000293:Adolescent; D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D008875:Middle Aged; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D010865:Pilot Projects; D011247:Pregnancy; D014590:Uterine Contraction / Q000187:drug effects
D010120:Oxytocics; D016595:Misoprostol