Background: Amniotomy and oxytocin infusion are the routine methods most frequently applied to induce labor. These methods are not effective when the cervix is unripe. Prostaglandins may accelerate the process of cervical ripening independently of the stimulation of uterine contractions, since they induce the formation of a gap junction (spread of excitation) and release uterine contractions. The purpose of this study is a comparative analysis of the effectiveness and safety of misoprostol and PGE2 in the process of cervical ripening and inducing labor in patients at full term delivery with a live fetus and indications for inducing labor due to an unripe uterine cervix.
Material and methods: The experimental group consisted of 30 patients at 38-41 weeks of gestation who received misoprostol administered into the posterior vaginal fornix (group M). The control group included 26 patients at 39-42 weeks of gestation in whom labor was induced using natural prostaglandin E(2) (group P).
Results: There were no statistically significant differences in maternal age, body weight and height, or uterine cervical ripening between the two groups of patients. The average time of gestation was 0.92 weeks shorter in group M. The time from administration of the drug to the onset of regular contraction activity of the uterus and delivery of an infant was shorter in the group of patients receiving misoprostol intravaginally.
Conclusions: Our results would seem to indicate that misoprostol is an effective drug that can be used for elective preinduction and induction of labor. However, the application of this drug to induce labor with a live fetus requires special caution and care, as well as continuous cardiotocographic monitoring to assure the safety of both the mother and the infant.