Pilot Study of Labor Induction with Titrated oral Misoprostol

Abstract

Titrated oral misoprostol is a safe and effective method of labor induction because the dosage can be adjusted according to individual response.

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

“…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.…”

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

“…However, excessive uterine contractility resulting in fetal distress is a cause for concern 7–18 . Based on pharmacokinetics 19 and the findings of a previously reported clinical trial including lower incidence of uterine hyperstimulation and a shorter active phase interval, 20,21 it appears reasonable to use titrated oral misoprostol solution for labor induction in consideration of individual differences and responses. Because labor induction with titrated oral misoprostol solution is effective and safe, it has become the standard method used in our obstetric unit since 2004.…”