Vaginal misoprostol for cervical ripening and induction of labour

Misoprostol for labor induction in term pregnancy

“…One frequently recommended dosing scheme includes administration of misoprostol 25 mcg vaginally every 4-6 h. Several publications summarize the results of these trials. The Cochrane Database has published several meta-analysis on misoprostol for labor induction including its use in vaginal [28], oral [29], as well as buccal or sublingual [30] administration routes. In these reviews, which are based on extensive literature searches and meta-analysis of study results, misoprostol has been shown to be more effective that conventional methods for labor induction.…”

“…However, a vaginal dose of 25 mcg is often recommended as the more prudent dose for labor induction because it is associated with a lower incidence of uterine hyperstimulation. It is also comparable to the 50-mcg dose in achieving delivery within 24 h [25,[40][41][42][43][44]. Doses higher than the 50 mcg have been associated with an increased risk of serious complications [45].…”

“…With these promising results, the use of misoprostol became an area of active research in the following decade. 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].…”

Contre l'utilisation du misoprostol dans le déclenchement du travail à terme en routine

“…Hofmeyr a réalisé une méta-analyse comportant 70 essais randomisés ayant testé le misoprostol par voie vaginale contre différentes stratégies (placebo, ocytocine, dinoprostone, différentes doses de misoprostol) [5].…”

Peripartaler Notfall nach Geburtseinleitung

“…Prostaglandinen sowie die vaginal-operative Entbindung [3,4,5]. Die kindliche Mortalität und das Risiko für eine peripartale Asphyxie des Neugeborenen mit hypoxischer Hirnschädigung sind hoch [4].…”