Induction of labor with vaginal misoprostol plus oxytocin versus oxytocin alone

Int J Gynaecol Obstet. 2010 Jul;110(1):64-7. doi: 10.1016/j.ijgo.2010.02.004. Epub 2010 Mar 26.

Abstract

Objective: To compare the effect of an oxytocin infusion alone or preceded by an intravaginal application of misoprostol for labor induction in women with term pregnancies and a low Bishop score.

Methods: This study randomized 100 multiparous women with singleton pregnancies over 38 weeks and a Bishop score less than 6 to receive either a single 50-microg dose of misoprostol intravaginally 3 hours before initiation of the oxytocin infusion or only an oxytocin infusion. The time from induction to delivery, the route of delivery, and maternal and fetal outcomes were analyzed.

Results: The mean time from induction to delivery was 9.36+/-1.97 hours in the misoprostol plus oxytocin group and 11.08+/-3.23 in the oxytocin alone group (P=0.002). The rates of vaginal delivery, 1- and 5-minute Agpar scores, placental abruption, and postpartum hemorrhage were similar between the 2 groups, as were the rates of admission to the neonatal intensive care unit. There were no cases of perinatal asphyxia.

Conclusion: A 50-microg intravaginal application of misoprostol before starting the oxytocin infusion is a more effective method of labor induction than an oxytocin infusion alone for our study population.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Abruptio Placentae / epidemiology
  • Administration, Intravaginal
  • Adult
  • Apgar Score
  • Drug Therapy, Combination
  • Female
  • Humans
  • Infant, Newborn
  • Infusions, Intravenous
  • Labor, Induced / methods*
  • Misoprostol / administration & dosage
  • Misoprostol / therapeutic use*
  • Oxytocics / administration & dosage
  • Oxytocics / therapeutic use*
  • Oxytocin / administration & dosage
  • Oxytocin / therapeutic use*
  • Postpartum Hemorrhage / epidemiology
  • Pregnancy
  • Pregnancy Outcome
  • Time Factors

Substances

  • Oxytocics
  • Misoprostol
  • Oxytocin