Comparative Evaluation of 50 Microgram Oral Misoprostol and 25 Microgram Intravaginal Misoprostol for Induction of Labour at Term: A Randomized Trial

Rahman, Hafizur; Pradhan, Anup; Kharka, Latha; Renjhen, Prachi; Kar, Sumit; Dutta, Sudip

doi:10.1016/s1701-2163(15)30931-2

Cited by 27 publications

(41 citation statements)

References 18 publications

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“…7 LSCS rates in both oral (13.6%) and vaginal (16%) misoprostol was comparable. This was similar to findings by Rehman H et al and Hall et al 6,8 Higher incidence of foetal distress in vaginal group could be due to slight increase in hyperstimulation of uterus. Similar findings were observed by Shetty A et al 9 Significantly increased number of patients in oral group (48%) required oxytocin augmentation compared to vaginal group (34%) similar to other studies by Rasheed R et aland Shetty A et al 7,10 This indicates less bioavailability of oral misoprostol due to first pass effect in liver.…”

Section: Discussionsupporting

confidence: 92%

“…Similar findings were observed by Shetty A et al 9 Significantly increased number of patients in oral group (48%) required oxytocin augmentation compared to vaginal group (34%) similar to other studies by Rasheed R et aland Shetty A et al 7,10 This indicates less bioavailability of oral misoprostol due to first pass effect in liver. The higher incidence of hyperstimulation and tachystole in vaginal group was observed in other studies too Rasheed R et al, Rehman H et al and A Shetty et al 6,7,9 This can be explained by the fact that the systemic bioavalability of vaginally administered misoprostol is three times that of oral route and hence increased uterine activity. 5 The nonsignificant increase in meconium stained liquor in vaginal group could be due to hyperstimulation.…”

Section: Discussionmentioning

confidence: 56%

“…This was similar to C. David Adnir et al 4 This clinical observation is strengthened by the study of Zieman et al who found that maximum plasma concentration of misoprostol was reached 34 minutes after oral dosing and 80 minutes after vaginal administration. 6 Majority of cases with vaginal misoprostol delivered is the single dose of misoprostol (48.8%) compared to 32% in oral group. This may be due to the systemic bioavailability of vaginal misoprostol in 3 times that of oral route.…”

Section: Discussionmentioning

confidence: 97%

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Efficacy of 50µg oral misoprostol versus 25µg vaginal misoprostol in induction of labor

Viswanathan

Raghunath

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Misoprostol is the latest drug for induction of labour which is cheap and stable at room temperature. Our study was conducted to test the efficacy of misoprostol for labor induction through oral and vaginal route.Methods: 250 women who required induction of labor at Govt. Medical College, Kottayam was included in this study. Both oral misoprostol 50µg and vaginal misoprostol 25µg 4 hourly upto maximum of four doses were used for induction of labor as per consultant’s preference. Out of these 125 patients were selected for study in both groups. Singleton term pregnancies with cephalic presentation were selected. The mean induction pain interval, induction delivery interval, mode of delivery, maternal complications like uterine contraction abnormalities, neonatal complications were observed.Results: Induction to pain interval was shorter in oral misoprostol group compared to vaginal misoprostol group (2.48+1.3 hours vs. 3.91+2.17 hours P ≤0.001). But the mean induction to delivery interval was comparable in both groups (12.98±3.04hrs vs. 12.59±3.28 hrs.) Vaginal delivery and cesarean section rate in both groups were comparable. The oral group required more number of misoprostol (>2 misoprostol 38.4% in oral 25.6% in vaginal p=0.030). There was insignificant increased incidence of uterine hyperstimulation in vaginal group. The neonatal outcome was comparable.Conclusions: Misoprostol administered either by oral or vaginal route was equally effective in induction of labor and found to be safe.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 97%

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Efficacy of 50µg oral misoprostol versus 25µg vaginal misoprostol in induction of labor

Viswanathan

Raghunath

2017

Int J Reprod Contracept Obstet Gynecol

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“…For example, eligibility for women in the study by Jindal et al [12] included ruptured membranes, which have been widely studied in oral misoprostol studies. The Jindal study also required Bishop score ≤ 4, compared with ≤6 in the study by Rahman et al [15]. Women in the Nagpal study [12] were given oxytocin if they were not in active labor after the maximum of 3 doses.…”

Section: Discussionmentioning

confidence: 99%

Oral Misoprostol 2 Hourly for Labor Induction

Kafy¹

2018

OJOG

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The objective of this study was to assess the efficacy and safety of the 2 hourly oral misoprostol for labor induction. Between May and November 2013, the hospital records of 83 women who were induced for labor and met the eligibility criteria were retrospectively reviewed. Eligibility criteria were singleton pregnancy of at least 34 weeks' gestation and a baseline Bishop score < 6. Women with a previous cesarean section or other uterine surgery, severe pregnancy-induced hypertension, and parity of 4 or more were excluded. Oral misoprostol was administered as 20 µg 2 hourly unless active labor. A maximum of 12 doses was allowed. The age of the women was 27.9 ± 5.3 years (mean ± SD). Vaginal delivery within 24 hours occurred in 38 (45.8%) women. Cesarean delivery occurred in 17 (20.5%) women. Although more parous women achieved vaginal delivery within 24 hours (52.6%) compared with nulliparous women (40.0%), the difference was not significant (P = .35). Uterine tachysystole occurred in 12 (14.5%) women. No perinatal deaths or neonatal intensive care unit admission occurred in the study group. Evidence supporting an optimal regimen is lacking, and additional research is warranted to optimize the use of oral misoprostol for the induction of labor.

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“…In our study, these charge codes were used to identify secondline uterotonics (methylergonovine maleate, carboprost, or misoprostol) that were used during the hospitalization for delivery. Because misoprostol at low doses (i.e., oral 50 µg or intravaginal 25 µg to a cumulative dose < 250 µg) can also be used as an induction drug, 19 we considered misoprostol as a second-line uterotonic only if the total dose was in excess of 400 µg and if the patient did not have an ICD-9 CM procedure code indicating medical induction of labor.…”

Section: Exposurementioning

confidence: 99%

Patterns of Second-Line Uterotonic Use in a Large Sample of Hospitalizations for Childbirth in the United States

Bateman

Tsen

et al. 2015

Survey of Anesthesiology

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Comparative Evaluation of 50 Microgram Oral Misoprostol and 25 Microgram Intravaginal Misoprostol for Induction of Labour at Term: A Randomized Trial

Cited by 27 publications

References 18 publications

Efficacy of 50µg oral misoprostol versus 25µg vaginal misoprostol in induction of labor

Efficacy of 50µg oral misoprostol versus 25µg vaginal misoprostol in induction of labor

Oral Misoprostol 2 Hourly for Labor Induction

Patterns of Second-Line Uterotonic Use in a Large Sample of Hospitalizations for Childbirth in the United States

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