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Randomized Controlled Trial
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Korean J Obstet Gynecol. 2002;45(3):438-442. Published online March 1, 2002.
- Comparison of Two Dose Regimens of Misoprostol for Cervical Ripening and Labor Induction.
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Seung Kil We, Tae Bok Song, Yoon Ha Kim, Ji Soo Byun, Hoon Park, Kwang Pil Jeong, Yong Sik Kim
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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.
Keywords :misoprostol;labor induction;cervical ripening;regimen
