Misoprostol use for cervical ripening and induction of labour in a Nigerian teaching hospital.
BACKGROUND
Induction of labor is always a challenge to many an obstetrician more so when the cervix is unfavorable.


OBJECTIVE
To determine the efficacy and safety ofmisoprostol in cervical ripening and labour induction.


METHODS
Aprospective study spanning 2 years and involving 151 patients admitted for cervical ripening and induction of labor at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. 50 microgram (mcg) ofmisoprostol was inserted vaginally every 4 hours until cervix became favorable or onset of labor.


RESULTS
Main indications for induction of labour were prolonged pregnancy and hypertensive diseases of pregnancy. An average of 2 insertions of 50 mcg tablet was used to achieve cervical ripening in 107 patients (71%) and 80% (120) had spontaneous labor within 10 hours of insertion. The mean insertion-labor interval was 7.86 hours (SD +/- 2.5). The average duration of labour was 9.36 hours (SD +/- 2.9). Vaginal delivery was achieved in 96% of the patients. Uterine hyperstimulation occurred in 9 patients but there was no case of uterine rupture.


CONCLUSIONS
Misoprostol was effective and safe in cervical ripening and induction of labor with a vaginal delivery rate of 96%. It should be an essential drug in obstetric practice especially in low resource settings.
Ekele
B A
BA
Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. bissekele@yahoo.com
Nnadi
D C
DC
Gana
M A
MA
Shehu
C E
CE
Ahmed
Y
Y
Nwobodo
E I
EI
D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D020070:Cervical Ripening; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D009549:Nigeria; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D014597:Uterine Rupture
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol