OBJECTIVE: We sought to compare the efficacy and safety of oral misoprostol administered to patients with the efficacy and safety in a control group treated with a Foley catheter and oxytocin for induction of labor. STUDY DESIGN:Two hundred patients requiring induction of labor at term with a Bishop score of </=5 were randomized to receive oral misoprostol or a cervical Foley catheter plus oxytocin. Patients in the misoprostol group received 50 microg at 4-hour intervals for a maximum of 6 doses or until an adequate contraction pattern developed. Those in the control group had a Foley catheter inserted in the cervix, whereas oxytocin was administered intravenously by a standard incremental infusion protocol to a maximum dose of 36 mU/min. RESULTS: In multiparous patients the percentage delivered of their neonates within 24 hours and the median induction-to-delivery times were similar in the 2 groups. In nulliparous patients, however, delivery within 24 hours was significantly less likely in the misoprostol group (53.4% vs 82. 5%; P <.001), and the median induction-to-delivery time was longer (23.3 hours vs 17.2 hours; P <.01). There were no differences in the incidence of meconium, chorioamnionitis, low Apgar scores, or cesarean delivery. The incidence of hyperstimulation was higher in the oxytocin-Foley group (4.1% vs 13.1%; P =.02). CONCLUSION:Oral misoprostol is as effective as oxytocin-Foley catheter for inducing labor in multiparous women. Misoprostol appears less efficacious in nulliparous patients.
RCT Entities:
OBJECTIVE: We sought to compare the efficacy and safety of oral misoprostol administered to patients with the efficacy and safety in a control group treated with a Foley catheter and oxytocin for induction of labor. STUDY DESIGN: Two hundred patients requiring induction of labor at term with a Bishop score of </=5 were randomized to receive oral misoprostol or a cervical Foley catheter plus oxytocin. Patients in the misoprostol group received 50 microg at 4-hour intervals for a maximum of 6 doses or until an adequate contraction pattern developed. Those in the control group had a Foley catheter inserted in the cervix, whereas oxytocin was administered intravenously by a standard incremental infusion protocol to a maximum dose of 36 mU/min. RESULTS: In multiparous patients the percentage delivered of their neonates within 24 hours and the median induction-to-delivery times were similar in the 2 groups. In nulliparous patients, however, delivery within 24 hours was significantly less likely in the misoprostol group (53.4% vs 82. 5%; P <.001), and the median induction-to-delivery time was longer (23.3 hours vs 17.2 hours; P <.01). There were no differences in the incidence of meconium, chorioamnionitis, low Apgar scores, or cesarean delivery. The incidence of hyperstimulation was higher in the oxytocin-Foley group (4.1% vs 13.1%; P =.02). CONCLUSION: Oral misoprostol is as effective as oxytocin-Foley catheter for inducing labor in multiparous women. Misoprostol appears less efficacious in nulliparous patients.
Authors: G Shechter-Maor; G Haran; D Sadeh-Mestechkin; Y Ganor-Paz; M D Fejgin; T Biron-Shental Journal: J Perinatol Date: 2014-10-02 Impact factor: 2.521
Authors: Mieke L G Ten Eikelder; Femke Neervoort; Katrien Oude Rengerink; Gert J van Baaren; Marta Jozwiak; Jan-Willem de Leeuw; Irene de Graaf; Maria G van Pampus; Maureen Franssen; Martijn Oudijk; Paulien van der Salm; Mallory Woiski; Paula Jm Pernet; A Hanneke Feitsma; Huib van Vliet; Martina Porath; Frans Roumen; Erik van Beek; Hans Versendaal; Marion Heres; Ben Willem J Mol; Kitty W M Bloemenkamp Journal: BMC Pregnancy Childbirth Date: 2013-03-19 Impact factor: 3.007
Authors: Marieke Dt de Vaan; Mieke Lg Ten Eikelder; Marta Jozwiak; Kirsten R Palmer; Miranda Davies-Tuck; Kitty Wm Bloemenkamp; Ben Willem J Mol; Michel Boulvain Journal: Cochrane Database Syst Rev Date: 2019-10-18
Authors: Robbie S Kerr; Nimisha Kumar; Myfanwy J Williams; Anna Cuthbert; Nasreen Aflaifel; David M Haas; Andrew D Weeks Journal: Cochrane Database Syst Rev Date: 2021-06-22
Authors: Maria Andrikopoulou; Elisa T Bushman; Madeline M Rice; William A Grobman; Uma M Reddy; Robert M Silver; Yasser Y El-Sayed; Dwight J Rouse; George R Saade; John M Thorp; Suneet P Chauhan; Maged M Costantine; Edward K Chien; Brian M Casey; Sindhu K Srinivas; Geeta K Swamy; Hyagriv N Simhan Journal: Am J Perinatol Date: 2021-08-05 Impact factor: 1.862