Comparison of labor induction with titrated oral misoprostol solution between nulliparous and multiparous women

Abstract

Titrated oral misoprostol solution is a promising method of labor induction for both nulliparous and multiparous women.

Role of titrated low dose oral misoprostol solution in induction of labour

“…Similar results were seen in the studies conducted by Ho et al 8 . and Cheng et al 10 , with none of the neonates in the misoprostol group having an Apgar score of <7 at 5 minutes. In all the above mentioned studies, misoprostol was used in low doses.…”

“…This was much lower than the incidence quoted by various authors. [8][9][10][11] The reason for this variation may be associated with the different dosage regimen of misoprostol used in different studies, as well as with different individual response to misoprostol. It is possible that the individual response of women to misoprostol may be dependent on drug absorption, peak levels reached and different action on uterus in different population groups.…”

“…This observation has prompted various studies using misoprostol in low doses as oral titrated solution and it has been found to be safer in terms of incidence of uterine hyperstimulation and fetal distress. [8][9][10][11] Based on these findings, this study was carried out in women with Bishop Score >6, using low dose titrated oral misoprostol solution for induction of labour. This method of induction was compared with titrated intravenous oxytocin in terms of labour outcomes, efficacy, adverse effects and neonatal outcomes.…”

Pharmacokinetic Analysis of Hourly Oral Misoprostol Administration – A Pilot Study

“…Therefore, there will be little risk of maternal tachysystole or fetal hypoxia arising from titrated oral misoprostol. The small, frequent of titrated oral misoprostol administration [4,13,[15][16][17] in labor induction or augmentation was safe in clinical practice according to these findings.…”

“…In one pilot study, small, frequent (every 2 hours), titrated doses of oral misoprostol minimized the risk of uterine hyperstimulation and prevented fetal hypoxia [11,12]. Investigators developed an advanced approach with hourly oral misoprostol administration relative to uterine response for labor induction or augmentation at term or for terminating mid-trimester pregnancies [4,[13][14][15][16][17]; they achieved a high rate of success within 24 hours. According to the results of titration studies, misoprostol is an ideal candidate for labor induction and augmentation due to its convenience of administration and cervical ripening characteristics.…”