ABSTRACT
To find out safety and efficacy of Misoprostol in cervical ripening and induction of labour to achieve vaginal delivery Design: Prospective observational study Setting: Dept. of Obstetrics and Gynecology, Khulna Medical College, Bangladesh Patients Et From January 2002 to December 2003, 5197 obstetric patients were received for delivery. This included 251 eclampsia patients. Out of the 251 Eclampsia patients, 81 patients [Primigravida 49 and multigravida 32] with unripe cervix were selected for induction of labour using Misoprostol tablet 1/4 th mixed with K-Y Jelly. Misoprostol application was stopped after third dose if there was no progress in cervical dilatation or effective uterine contractions and patients were taken for caesarean operation. From Misoprostol insertion to delivery time was 4-24 hours. Vaginal delivery was achieved in 80.2%, which included spontaneous, forceps and vacuum extraction. Caesarean section rate was 19.7%. Indications for C. Section included Misoprostol unresponsiveness 11% and fetal distress in 8.6%. Oxytocin augmentation was required in 32% of cases. Term babies were 58%. Intrauterine death and neonatal deaths were 9.8% and 8.6% respectively. Hyper stimulation and postpartum haemorrhage was seen in 2.4% and 3.7% of patients respectively Conclusions: Intravaginal Misoprostol is well tolerated and is very effective for the induction of labour in eclampsia. It helps vaginal delivery in toxemic patients, reduces maternal morbidity, mortality and hospital stay