[Titrated oral misoprostol solution compared with oxytocin for induction of labor in women with unfavorable cervix]

Uterine contractions and an appropriate cervix are two important factors in labor contributing to good pregnancy outcomes. Oxytocin and prostaglandins, such as misoprostol, are used for the induction of labor. Misoprostol is used for cervical ripening and labor induction. The aim of this trial was to compare the efficacy and safety of titrated oral misoprostol solution with oxytocin for labor induction in pregnant women with an unfavorable cervix. In this randomized double-blind clinical trial, 140 women with a gestational age of 34-42 weeks and an unfavorable cervix were recruited. The participants had an indication for labor induction and had been referred to the Women's Hospital in Tehran, Iran between January 2010 and January 2011. The participants were randomly assigned to receive 20 micro g/hour titrated oral misoprostol plus intravenous placebo or 6 mU/min oxytocin plus oral placebo. In case contractions were inadequate, the drug doses were gradually increased. Pharmacological complications, the mean interval from the start of induction till vaginal delivery and delivery type were monitored and analyzed in both groups. The mean interval from the start of induction till vaginal delivery in misoprostol group was shorter than the oxytocin group [11.07 +/- 3.42 vs. 14.87 +/- 3.21 hours, P=0.001]. The frequency of pharmacological complications and vaginal or cesarean deliveries were similar between the two groups [P>0.05]. Use of titrated oral misoprostol is a safe and effective method for labor induction in pregnant women with unfavorable cervix. Misoprostol is associated with a shorter interval from induction to vaginal delivery than oxytocin

Effect of metformin on diabetes mellitus prevention in pregnant women with risk factors

This study evaluated the efficacy and safety of metformin on prevention of gestational diabetes mellitus in women with high risk of GDM. Total number of 189 pregnant women aged between 25 to 35, and 10 to 14 weeks pregnancy, admitted to Mirza Koochakkhan Hospital, Tehran in January 2008 - January 2009 entered to this randomized controlled clinical trial. The women had one of the three risk factors; history of GDM, family history of diabetes, or BMI >/- 30 kg/m[2], with normal results in the glucose challenge test [GCT] or the glucose tolerance test [GTT]. Subjects were randomly split to two groups; 63 women [group A] who received metformin [500 mg, twice a day] and 126 women [group B] did not use metformin. Incidence of gestational diabetes was compared between two groups. The incidence of gestational diabetes was significantly different between two groups [%1.4 in group A,%15.4 in group B] [p<0.001]. The study also showed that the insulin requirement was significantly different between two groups after developing GDM [group A%3.6, group B%9.5, p=0.001]. Using Metformin can effectively reduce the incidence of GDM in pregnant women at risk