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Am J Perinatol. 2009 Oct;26(9):673-7. doi: 10.1055/s-0029-1220790. Epub 2009 Apr 29.

Outpatient oral misoprostol for prolonged pregnancies: a pilot investigation.

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  • 1Division of Maternal-Fetal Medicine, Women's Pavilion at Miller Children's Hospital, Long Beach Memorial Medical Center, Long Beach, California, USA. Cecilia_gaffaneylyons@pediatrix.com

Abstract

We evaluated the effectiveness of oral misoprostol for outpatient cervical ripening and labor induction in prolonged pregnancies. We performed a randomized, double-blind, placebo-controlled study of women at 40 to 42 weeks' gestation with well-dated pregnancies, singleton gestations, Bishop scores less than 6, vertex presentations, and intact membranes. Subjects received either oral misoprostol 100 microg or placebo daily for 3 days unless the subject developed significant cervical change or began labor spontaneously. Study drug was repeated every 24 hours for a maximum of three doses if subjects did not develop significant cervical change or enter labor. Induction of labor was not allowed while the subject was enrolled in the study. Forty-three subjects were randomized to receive misoprostol and 44 randomized to receive placebo. A significant difference was noted in reduction of time from study entry to both active phase (p < 0.001) and delivery (p < 0.001) in the misoprostol group. Fewer women remained undelivered after the 72-hour study period in the misoprostol group. There were no differences in route of delivery or neonatal outcomes between groups.

CONCLUSION:

Daily administration of oral misoprostol over 3 days to women with prolonged pregnancies shortened time intervals from dosing to entry into active labor and delivery compared with placebo.

Thieme Medical Publishers.

PMID:
19404900
[PubMed - indexed for MEDLINE]
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