The Experience of a Developing Country in Using Misoprostol for Induction of Labor
Keywords:Misoprostol, labor, neonatal outcome, maternal outcomes, maternal outcomes
Objective: Assess the maternal and neonatal outcomes after use of vaginal misoprostol for induction of
labor in resource limited situations
Materials and Method: A prospective case control study, it included 200 pregnant women (100 of whom
required Induction of labor for different indications and the other 100 pregnant women were in spontaneous
labor. The route of misoprostol tablet administration was vaginal, starting with 25mcg every 6 hours with
maximum 4 doses.
Results: Median time from misoprostol administration to vaginal delivery was 16.0 hours, the most common
indications of misoprostol were prelabor ruptured membrane 34%, post-date 27%, and oligohydramnios
with fetal growth restriction 19%.
The Apgar score of the neonates in 1 minute was < 7 in 45%, however it was down to 6% at 5 minutes
of delivery in induced women. Admission to the neonatal care unit (NCU) in induced women was 40%,
whereas 21% in women with spontaneous labor, the rate of admission to NCU in induced women was
significantly higher in nulliparous women 73.8% compared to multiparous women 15.5% p<0.001, and also
higher in women received more than 2 doses of misoprostol.
Conclusion: Misoprostol is effective and safe for induction of labor when clinically indicated, however
women should be counseled carefully regarding the maternal and fetal complications prior to induction with
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