title: Safety and efficacy of misoprostol for induction of labour.
abstract: BACKGROUND
  Induction of labour is widely carried over the world in cases where continuation of pregnancy is hazardous to mother or fetus. Varieties of techniques are available for induction of labour. Prostaglandin is one of the most effective means for achieving cervical ripening and induction of labour. This study was carried out to see safety and effectiveness of Misoprostol for induction of labour.
  
  
  METHODS
  This prospective study was carried out at Kathmandu University Hospital, Dhulikhel from Jan 2008 to Aug 2009. A total of 70 patients were included in this study. All patients received 50 μg of Misoprostol in the posterior fornix with maximum dose up to 3 doses at interval of 6 hours. Bishops scoring was reviewed each time before application of Misoprostol. When favourable cervix along with good uterine contraction is noted then augmentation with Oxytocinon was done holding Misoprostol. The measures used for the analysis of effectiveness and safety of Misoprostol were change in bishop score, total dose required, need for augmentation, side effects, duration of first, second and third stages of labour, duration from induction till delivery, mode of delivery and neonatal outcome. The primary outcome measures were induction to delivery interval and caesarean section rate.
  
  
  RESULTS
  Out of 70 patients, 21 (30%) required augmentation. Among 70 patients, 46 (65%) underwent normal delivery, 6 (8.6%) underwent instrumental delivery and 18 (25%) patients underwent cesarean section for various indications (p=0.00). Total 31 (44%) patients delivered within 10 hours of induction, 16 (22%) within 15 hours and 4 (4.7%) took more than 18 hours. Duration of second stage of labour was also found to be shortened with use of Misoprostol for induction of labour. Duration of second stage of labour was less than 30 minutes in 42 (60%) cases and more than 30 minutes in 9 (17%) cases.
  
  
  CONCLUSIONS
  Misoprostol is an effective cervical ripening agent with favorable outcome and comparable with other inducing agents.
authors: Department of Gynecology and Obstetrics, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal. anjanadangol@yahoo.com
authors: A S
authors: AS
authors: Dongol
authors: S
authors: S
authors: Shakya
authors: C D
authors: CD
authors: Chawla
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000527:Alprostadil / Q000009:adverse effects / Q000627:therapeutic use; D020070:Cervical Ripening / Q000187:drug effects*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D013997:Time Factors; D016064:Vaginal Birth after Cesarean; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D014665:Vasodilator Agents; D016595:Misoprostol; D000527:Alprostadil