[Induction of labour at term with misoprostol: the experience of a Tunisian maternity ward]. / Déclenchement du travail à terme par le misoprostol: expérience d'une maternité tunisienne.

To evaluate the efficacy and safety of vaginal misoprostol for term labour induction. A prospective study conducted at the Department of Obstetrics and Gynecology B of hospital Charles Nicolle, Tunis, over a period of 4 months. The group of subjects, selected to represent the population of interest, were pregnant patients at term undergoing cervical ripening. Patients received 50 mcg vaginal misoprostol every 12 hours. The parameters studied were: contractile abnormalities, abnormalities of fetal heart rate (FHR), mode of delivery, delayed delivery and neonatal status. 44 patients underwent cervical ripening with misoprostol. The average term was 40 WA. Nulliparous rate was 23/44 (52%). Vaginal birth rate was 31/44 (70.4%). 84% of patients received a single dose of misoprostol. FHR abnormalities were observed in 14/44 (32%). The rates of meconium-stained amniotic fluid was 12/44 (27%). Apgar score of less than 7 at 5 minutes was found in 7/44 (16%). A case of uterine rupture occurred in a primipara after a single dose of misoprostol. Our results are disappointing due to the occurrence of 1 uterine rupture and of 1 significant neonatal morbidity. Other multicentre prospective studies will be useful to better ensure the effectiveness but primarily the safety of low-dose misoprostol for induction of labour at term.

[Efficacy of misoprostol for medical termination of pregnancy in second trimester : Prospective study]. / Efficacité du misoprostol pour l'interruption médicale de grossesse au 2éme trimestre: Etude prospective.

AIM: To investigate the efficacy of misoprostol used alone, and the time of fetal expulsion for medical termination of pregnancy in the second trimester. PATIENTS AND METHODS: 50 patients were enrolled in a prospective study over two years and in whom termination of pregnancy was indicated between 14 and 28 weeks of amenorrhea. Misoprostol was reported in a well-defined protocol: group 1: 2 tablets every 3 hours as intra vaginal, group 2: half dose for women bull 4th or more or carrying a scarred uterus for terms greater than or equal to 22 weeks of amenorrhea. RESULTS: 48 patients expelled misoprostol alone and we have used an aspiration in two cases. The period of expulsion for 24 hours was 97% for the first group and 90% for the second. CONCLUSION: using misoprostol within this protocol is effective and reduce the time required for the fetal expulsion of the second trimester pregnancy.