A randomized comparison between intravaginal misoprostol and prostaglandin E2 for labor induction

• Published in: Archives of gynecology and obstetrics 2007-04, Vol.275 (4), p.263-267
• Main Authors: Sifakis, S, Angelakis, E, Avgoustinakis, E, Fragouli, Y, Mantas, N, Koukoura, O, Vardaki, E, Koumantakis, E
• Format: Article
• Language: English
• Subjects: Administration, Intravaginal; Adolescent; Adult; Dinoprostone - therapeutic use; Drug Administration Schedule; Female; Heart Rate, Fetal - drug effects; Humans; Induced labor; Labor, Induced - methods; Misoprostol - therapeutic use; Oxytocics - therapeutic use; Pregnancy; Time Factors; Treatment Outcome
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-006-0258-4

The aim of this randomized study was to compare the effectiveness, safety, and side effects of 6 h vaginal misoprostol versus vaginal prostaglandin E(2) (PGE(2)) for labor induction. Fifty microgram of misoprostol was given intravaginally in the misoprostol group (204 women), and 3 mg PGE(2) was given intravaginally in the PGE(2) group (211 women). In both groups, the dose was repeated every 6 h for a maximum of three doses, until active labor was achieved. Artificial rupture of membranes and oxytocin infusion was used during labor in both groups where it was indicated. The mean interval from the institution of labor induction to delivery was 11.3 +/- 8.6 h for the misoprostol group, and 15.7 +/- 9.3 h for PGE(2 )group (P < 0.05). In the misoprostol group, oxytocin was used less frequently, but there was a higher prevalence of tachysystole. No statistically significant differences were observed between the two groups as regard abnormal patterns of fetal heart rate, the mode of delivery, and the need for neonatal intervention. In conclusion, the intravaginal administration of 50 mug misoprostol at 6 h interval (maximum three doses) is comparable in safety, but more effective for induction of labor than 3 mg intravaginal PGE(2).