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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.


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.


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.

[PubMed - indexed for MEDLINE]
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