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Korean Journal of Obstetrics & Gynecology 2002;45(3):438-442.
Published online March 1, 2002.
Comparison of Two Dose Regimens of Misoprostol for Cervical Ripening and Labor Induction.
Seung Kil We, Tae Bok Song, Yoon Ha Kim, Ji Soo Byun, Hoon Park, Kwang Pil Jeong, Yong Sik Kim
Departments of Obstetrics and Gynecology, Chonnam National University Medical School and Chonnam National University Research Institute of Medical Sciences, Kwangju, Korea.
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.
Key Words: misoprostol, labor induction, cervical ripening, regimen


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