Misoprostol for cervical ripening and labor induction: A meta-analysis

Abstract

Published data confirm the safety and efficacy of intravaginal misoprostol as an agent for cervical ripening and labor induction.

Outcome of Induction of Labor: A Prospective Study

“…Its use may decrease the need for oxytocin induction and reduce the induction-todelivery intervals (Sanchez-Ramos and colleagues in 1997). [9] Reviewed Cochrane data base support these recommendation, but caution that rates of uterine hyper-stimulation with adverse fetal heart rate changes are increased with its use leading to increased cesarean rates. It can also significantly Section: Obstetrics & Gynaecology increase uterine tachysystole, meconium passage, and meconium aspiration compared with PGE2 gel (Wing and co-workers, 1995a).…”

Use of misoprostol on an outpatient basis for postdate pregnancy

“…It was pleasing to observe no abnormal contractile patterns with the doses employed. In other studies, uterine tachysystole, with or without FHR abnormalities, has been reported to occur with various frequencies dependent on dosing and route of administration [12][13][14][15][16][17][18][19][20][21]. Perhaps the absence of abnormal contractile patterns can be attributed to use of oral administration and low dosing, as compared to studies that have specifically addressed labor induction rather than outpatient ripening [12,13].…”

“…A number of published controlled trials have shown that misoprostol (a synthetic PGE 1 analog) is an effective agent for cervical ripening and labor induction in patients at term [12][13][14][15][16][17][18]20,21]. We have previously reported our experience with 200 Ag oral vs. 50 Ag intravaginal doses for inpatient labor induction at term [19].…”

Misoprostol for labor induction in term pregnancy

“…Many studies, including several systematic reviews and metaanalysis of published randomized trials [25][26][27][28][29][30], have shown misoprostol to be more effective than a placebo or other prostaglandins for the induction of labor. Misoprostol can achieve a higher rate of vaginal delivery within 24 h, a shorter induction-to-delivery interval, and significantly lower overall cesarean section rates than pooled figures for the control groups [31]. It minimizes the expenses associated with prostaglandin E2 analogs and intravenous oxytocin infusion.…”