Induction of labor with titrated oral misoprostol solution versus oxytocin in term pregnancy: randomized controlled trial

Abstract

Misoprostol is a safe and effective drug with low complications for the induction of labor. Failure is seen less with misoprostol and caesarean sections are less frequently indicated as compared to oxytocin.

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

“…This difference may be explained by the fact that the maximum dose of oxytocin used in present study was 64 mIU, while that used by Ho et al 8 . (20 mIU) and Aalami-Harandi et al 9 (34 mIU) was much lower.…”

“…This study found significantly lower number of neonates with Apgar score of <7 at 5 minutes in group 1 (given low dose misoprostol) as compared to group 2 (given oxytocin) in the present study (p=0.038), while the other authors (Ho et al 8 . and Aalami-Harandi et al 9 ) did not find a significant difference between misoprostol and oxytocin in terms the incidence of neonates with Apgar score of <7 at 5 minutes (p <0.05). This difference may be explained by the fact that the maximum dose of oxytocin used in present study was 64 mIU, while that used by Ho et al 8 .…”

“…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.…”

Oral Misoprostol 2 Hourly for Labor Induction

“…In the current study, the 83 women treated with 20 µg of an oral misoprostol solution 2 hourly had lesser delivery success at 24 hours of 45.8% compared with 79.7% with 25 µg misoprostol 2 hourly for 12 doses [9]. This subject could be treated a maximum of 12 times with 20 µg oral misoprostol solution (maximum possible dose: 250 µg).…”