Vaginal misoprostol in managing premature rupture of membranes

Abstract

We compared the efficacy of misoprostol with that of prostaglandin E2 in cervical ripening and labour induction. Thus 238 women with rupture of membranes beyond 36 weeks gestation without labour were randomized to receive 50 microg misoprostol vaginal gel or 5 mg of prostaglandin E2 gel. Bishop score was evaluated before drug application and 6 hours later. Clinical data and perinatal outcome were recorded. Mean time from induction to delivery and the need for oxytocin were significantly less in the misoprostol group. There were no significant differences in spontaneous labour rate, type of delivery and perinatal outcome. It is concluded that intravaginal misoprostol is safe and more effective than prostaglandin E2 for preinduction cervical ripening in premature rupture of membranes beyond 36 weeks gestation.

Comparative study of dinoprostone and misoprostol for induction of labor in patients with premature rupture of membranes after 35 weeks

“…Definitions of fetal acidosis vary widely, though severe fetal acidosis is regularly defined by an umbilical arterial pH < 7 26 – 29 . We found no significant between-group difference in Apgar score at birth, in line with all literature studies comparing misoprostol and prostaglandins 14 , 18 – 20 .…”

“…The rate of vaginal delivery was greater with dinoprostone for induction of labor than with misoprostol (88.7% vs. 82.3%; p = 0.016). To date, no other study has reported this result, though Ayad et al reported a finding at the limit of significance 14 for induction of labor in patients with PROM (Table 8 ). In a recent study, Mlodawski et al compared misoprostol vaginal insert versus dinoprostone vaginal insert for the induction of labor with intact membranes.…”