Comparison of Two Dose Regimens of Misoprostol for Cervical Ripening and Labor Induction / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: To compare the safety and efficacy of two dose regimens of intravaginally administered misoprostol (PGE1) for cervical ripening and labor induction. METHODS: One hundred patients with unfavorable cervix (including PROM) for labor induction were randomly assigned to group A and group B. Group A patients received 25 g of vaginal misoprostol every 4 hours with maximum of 6 doses and group B patients received 25 g, 50 g, 100 g, 100 g of misoprostol every 4 hours with maximum of 4 doses. Misoprostol was inserted to the posterior vaginal fornix. Successful induction was defined when Bishop score was increased to greater than 9 or regular uterine contractions were developed. The rates of successful induction, vaginal delivery, mean time from induction to delivery, drug side effects, and neonatal outcomes were compared. RESULTS: The average interval from start of induction to vaginal delivery was shorter in group B (780.1+/-313.0 minutes) than group A (1108.9+/-485.9 minutes) (p<0.01). The rate of vaginal delivery was higher in group B (42/50, 84.0%) than group A (35/50, 70.0%) although statistically not significant. The incidences of tachysystole, abnormal fetal heart rate tracing, meconium passage, low 1-min and 5-min Apgar scores, and admission to the neonatal intensive care unit were not different between two groups. CONCLUSIONS: Induction with misoprostol using dose-increasing schedule showed shorter time from induction to delivery and higher rate of successful induction than using same dose schedule without increase of side effects and adverse neonatal outcomes.