Misoprostol for induction of labor
Section snippets
Oral misoprostol
Alfirevic et al.8 published a recent Cochrane review on oral misoprostol including 76 trials that compared this route of administration with placebo and other methods for induction of labor. When compared to placebo, women treated with oral misoprostol were more likely to give birth vaginally within 24 h and need less oxytocin.8 Women who received oral misoprostol had lower cesarean rates when compared to women who received vaginal dinoprostone (RR = 0.88; 95% CI: 0.78–0.99) and when compared to
Vaginal misoprostol
Hofmeyr et al.5 published one of the largest meta-analyses on labor induction, including 121 trials of vaginal misoprostol. Their findings included that compared to placebo, vaginal misoprostol was associated with reduced failure to achieve vaginal delivery in less than 24 h (RR = 0.40; 95% CI: 0.22–0.7; 2 trials, 112 women).5 Compared to vaginal PGE2, intracervical PGE2, and oxytocin, vaginal misoprostol was again associated with reduced failure to achieve vaginal delivery in less than 24 h (RR
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Cited by (27)
Evening primrose oil for cervical ripening prior to labor induction in post-term pregnancies: A randomized controlled trial: Evening primrose oil for cervical ripening
2022, European Journal of Integrative MedicineCitation Excerpt :Misoprostol, a synthetic prostaglandin E1 analog, is commonly used off-label for cervical ripening and induction of labor in term and post-term pregnancies [15]. Although misoprostol has been shown to be effective in cervical ripening, it has been warned that its use may increase the risk of severe complications such as excessive uterine contractions and rupture compared to other methods [16]. Evening primrose oil (EPO) is the most common herbal preparation used by certified midwives in Iran; to induce cervical ripening in pregnant women before the induction of labor.
Cervical Ripening and Labor Induction and Augmentation, 5th Edition
2020, JOGNN - Journal of Obstetric, Gynecologic, and Neonatal NursingCitation Excerpt :Tachysystole and indeterminate or abnormal FHR changes have been associated with both the 25-mcg and the 50-mcg doses (Crane, Young, Butt, Bennett, & Hutchens, 2001; Kreft et al., 2014; McMaster et al., 2015; Penfield & Wing, 2017). Higher dosages have been associated with an increased rate of tachysystole (ACOG, 2009b; Kreft et al., 2014; McMaster, Sanchez-Ramos, & Kaunitz, 2015; Penfield & Wing, 2017; Stephenson & Wing, 2015). The incidence of tachysystole with and without indeterminate or abnormal FHR changes was significantly higher with misoprostol than with Cervidil, Prepidil, and oxytocin (Hofmeyr, Gülmezoglu, & Pileggi, 2010; Liu et al., 2014; Penfield & Wing, 2017; Stephenson & Wing, 2015).
Cervical Ripening and Labor Induction and Augmentation, 5th Edition
2020, Nursing for Women's HealthCitation Excerpt :The incidence of tachysystole with and without indeterminate or abnormal FHR changes was significantly higher with misoprostol than with Cervidil, Prepidil, and oxytocin (Hofmeyr, Gülmezoglu, & Pileggi, 2010; Liu et al., 2014; Penfield & Wing, 2017; Stephenson & Wing, 2015). A 4- to 6-hour interval between doses was associated with less uterine tachysystole than the 3-hour interval (ACOG, 2009b; Penfield & Wing, 2017; Stephenson & Wing, 2015). Uterine rupture is a complication of the use of misoprostol for cervical ripening and labor induction, especially for women who have uterine scars (FDA, 2015; Lydon-Rochelle, Holt, Easterling, & Martin, 2001; Penfield & Wing, 2017; Searle, 2018; Weeks et al., 2007).
A comparison of vaginal versus buccal misoprostol for cervical ripening in women for labor induction at term (the IMPROVE trial): a triple-masked randomized controlled trial
2019, American Journal of Obstetrics and GynecologyMaternal and neonatal outcomes with mechanical cervical dilation plus misoprostol compared to misoprostol alone for cervical ripening; a systematic review of literature and metaanalysis
2019, American Journal of Obstetrics and Gynecology MFMCurrent Resources for Evidence-Based Practice, July/August 2016
2016, JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing
D.A.W is a consultant for Ferring Pharmaceuticals and was a principal investigator for the multicenter Misoprostol Vaginal Insert Consortium for Ferring Pharmaceuticals.