Oral misoprostol for induction of labour

Oral misoprostol is more effective than placebo and as effective as vaginal misoprostol at inducing labour, and when used at a dosage of 20 mcg two-hourly results in fewer caesarean sections than vaginal dinoprostone. With low doses of oral misoprostol rates of uterine hyperstimulation seem to be equivalent to both placebo, vaginal dinoprostone, and vaginal misoprostol.

A Cochrane review included 76 studies with a total of 14 412 subjects. As compared with placebo (9 studies, n=1 109), women using oral misoprostol (OM)(a synthetic prostaglandin E1 analogue) were more likely to deliver vaginally within 24 hours (RR 0.16, 95% CI 0.05 to 0.49; 1 trial, n=96), needed less oxytocin (RR 0.42, 95% CI 0.37 to 0.49; 7 trials, n=933) and had a lower caesarean section rate (RR 0.72, 95% CI 0.54 to 0.95; 8 trials, n=1029).As compared with vaginal dinoprostone (12 studies, n=3 859), women given OM were less likely to need a caesarean section (RR 0.88, 95% CI 0.78 to 0.99; 11 trials, n=3 592).There was some evidence that they had slower inductions, but there were no other significant differences. As compared with intravenous oxytocin (9 studies, n=1 282 ),the caesarean section rate was significantly lower in women who received oral misoprostol (RR 0.77, 95% CI 0.60 to 0.98; 9 trials, n=1282), butthey had an increase in meconium-stained liquor (RR 1.65, 95% CI 1.04 to 2.60; 7 trials, n=1 172). 37 studies (n=6 417) compared oral and vaginal misoprostol and found no difference in the primary outcomes. However there were fewer babies born with a low Apgar score in the OM group (RR 0.60, 95% CI 0.44 to 0.82; 19 trials, 4009 babies).

Ədəbiyyat

1. Alfirevic Z, Weeks A. Oral misoprostol for induction of labour. Cochrane Database Syst Rev 2006;(2):CD001338 [Assessed as up-to-date: 17 January 2014]. .