A Comparison of the effect of Oral Misoprostol and Vaginal Misoprostol on the Labor Induction at Term / 대한산부인과학회지

ABSTRACT

OBJECTIVE: To compare the safety and the efficacy of oral 100 microgram versus vaginal 50 microgram misoprostol for labor induction at term. METHODS: Eighty patients with indicated for labor induction were randomized to receive either oral misoprostol 100 microgram or 50 microgram of vaginal misoprostol. In both groups, the dosage was repeated every 6 hours, if needed, to a maximum of four doses. We compared the Bishop score during labor induction, average interval from induction to delivery, vaginal delivery rate within 12 hours and 24 hours, mode of delivery, neonatal outcomes, and maternal complications between two groups. RESULTS: In two groups, demographic characteristics were similar. Regarding the change of Bishop score checked after 4 hours and 8 hours, it was statistically shown that the score was significantly high in oral misoprostol group compared to vaginal misoprostol group (5.9+/-1.4 vs. 5.1+/-1.1, p<0.05; 8.6+/-2.3 vs. 7.1+/-2.1, p<0.05). In nulliparous women, the average interval from induction to delivery was shorter in oral misoprostol group than in vaginal misoprostol group (927.4+/-344.7 minutes vs. 1130.6+/-297.0 minutes, p<0.01). In multiparous women, the average interval from induction to delivery was shorter in oral misoprostol group than in vaginal misoprostol group (674.2+/-110.4 minutes vs. 831.1+/-181.6 minutes, p<0.01). There was no clinical or statistical difference between two groups in mode of delivery, cesarean section rate, fetal heart rate abnormalities, tachysystole, hyperstimulation syndrome, meconium staining and fetal outcome (Apgar score at 1 and 5 minutes, birth weight). CONCLUSION: These results suggest that oral misoprostol 100 microgram is more effective for cervical ripening and induction of labor than vaginal misoprostol 50 microgram.