Labor induction with randomized comparison of cervical, oral and intravaginal misoprostol

Dadashaliha, Masoumeh and Fallah, Somayeh and Mirzadeh, Monirsadat (2021) Labor induction with randomized comparison of cervical, oral and intravaginal misoprostol. BMC Pregnancy Childbirth.

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Background: This study attempts to evaluate the safety and efectiveness of 50μgm intracervical misoprostol in comparison with intravaginal and sublingual for the induction of labor at term pregnant women. Methods: This study is designed as a parallel clinical trial study. Three hundred and ffteen term pregnancies requiring induction of labor were treated with the maximum used misoprostol intracervical, sublingual, and vaginal doses. Participants were randomly allocated into three groups of 105. The dose was repeated every 4h until adequate uterine contraction and Bishop Score were achieved. The duration of induction to births, time to the active phase, the rate of births, and the need for caesarean section were compared in three groups. Additionally, labor course and side efects were recorded and analyzed. Data were analyzed using SPSS software. A signifcance level of p< 0.05 was considered for statistical analyses. Findings: Labor was successfully induced in all cases most (63%) of which required a single dose of misoprostol. Ninety-three (93.0%, p< 0.05) cervical participants proceeded to vaginal births. This fgure was also the same in the vaginal and sublingual group of 83 cases (83.0%). The other 41 cases received caesarean section with more indications of failure to progress and meconium-stained liquor. The results indicated that 278 (92.7%) births were achieved in less than 10h. Time from start of medication to the active phase of labor and childbirth was 3.01±0.86 and 6.1±1.3h in the Cervical group, 4.2±0.66 and 8.4±0.92h in the sublingual group, and 5.06±1.1 and 9.2±1.5h in the vaginal group respectively (p<0.001). The Caesarean rate was lower in the cervical group than in the two other groups (p=0.05). No signifcant diferences were observed between the study groups in terms of Apgar score and meconium-stained amniotic fuid. Furthermore, no maternal and neonatal complications were observed. Conclusion: In addition to the sublingual and intravaginal routes of administration, intracervical misoprostol at a single dose of 50μgm appears to be an efective method for induction of labor in women with an unfavorable cervix. Like all medical interventions, a discussion of the risks, benefts, and alternatives to induction of labor with this medication in each woman should be undertaken before treatment. Trial registration: This clinical study was approved by the Iranian Registry of Clinical Trials with IRCT ID: IRCT201904 15043278N1. Registration date was on May 13, 2019 and May 27, 2019 respectively (http://www.irct.ir). Keywords: Misoprostol, Labor induced, Term birth

Item Type: Article
Subjects: R Medicine > R Medicine (General)
Divisions: University Portal > research center > Metabolic
Depositing User: pr Metabolic diseases research
Date Deposited: 14 Nov 2022 10:14
Last Modified: 14 Nov 2022 10:14
URI: http://eprints.qums.ac.ir/id/eprint/12213

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