Complications associated with second trimester inductions of labor requiring greater than five doses of misoprostol.

OBJECTIVE: To evaluate outcomes associated with induction at 14 weeks 0 days-23 weeks 6 days gestation that require five or less vs. six or more misoprostol doses. STUDY DESIGN: We performed a retrospective study of vaginal misoprostol inductions from January 2003 to February 2016 to assess complications based on number of misoprostol doses. RESULTS: Among 390 women receiving five or fewer doses and 78 women receiving six or more doses, we found similar rates of chorioamnionitis, postpartum hemorrhage, transfusion and retained placenta. CONCLUSION: Complication rates were comparable in women receiving more than five versus less than five misoprostol doses for labor induction in the second trimester. IMPLICATIONS: Women undergoing second trimester induction undelivered after five doses of misoprostol can receive additional doses without any concern for increased complications.