title: Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol.
abstract: OBJECTIVE
  To compare the efficacy and safety of two misoprostol dosing regimens for induction of labour in primiparous (1P) and multiparous (>1P) women.
  
  
  METHODS
  Retrospective study of induction of labour using vaginal misoprostol 25 μg vs. 50 μg every 6 h in 942 women at a tertiary centre. The main outcome variables are induction-to-delivery interval, latency period duration, vaginal delivery within 24 h, and maternal and foetal safety outcome.
  
  
  RESULTS
  With the 50 μg regimen, induction-to-delivery intervals were significantly shorter: 18.4 h vs. 24.6 h (1P) and 14 h vs. 17.9 h (>1P), as was latency period duration (by 5.4 and 4 h, respectively). Vaginal delivery within 24 h was significantly more frequent, as were non-reassuring foetal heart rate (1P: 20% vs. 14%) and tachysystole (1P: 31% vs. 11%; >1P: 21% vs. 7%). No uterine rupture was reported. Neonatal outcomes were similar except for significantly more frequent infant referral to neonatal intensive care in the >1P group receiving the 50 μg regimen (11% vs. 4%).
  
  
  CONCLUSIONS
  Vaginal misoprostol 25 μg seems to maintain efficacy with more acceptable maternal and neonatal safety. As induction of labour is an off-label use for misoprostol, safety should be prioritised with the lower dosage regimen despite the longer induction-to-delivery interval.
authors.forename: Martina
authors.initials: M
authors.lastname: Kreft
authors.forename: Franziska
authors.initials: F
authors.lastname: Krähenmann
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Roos
authors.forename: Juozas
authors.initials: J
authors.lastname: Kurmanavicius
authors.forename: Roland
authors.initials: R
authors.lastname: Zimmermann
authors.forename: Nicole
authors.initials: N
authors.lastname: Ochsenbein-Kölble
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007751:Labor, Induced / Q000009:adverse effects / Q000379:methods*; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010120:Oxytocics; D016595:Misoprostol