Titrated oral misoprostol solution versus vaginal misoprostol for labor induction

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• 作者：Alex S.R. Souza ; Francisco E.L. Feitosa ; Aur茅lio A.R. Costa ; Ana P.R. Pereira ; Andreza S. Carvalho ; Renata M. Paix茫o ; Leila Katz ; Melania M.R. Amorim
• 关键词：Clinical trial ; Induced labor ; Misoprostol
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：December, 2013
• 年：2013
• 卷：123
• 期：3
• 页码：207-212
• 全文大小：333 K

文摘

Objective

To determine the efficacy and safety of a titrated oral misoprostol solution compared with vaginal misoprostol tablets for labor induction.

Methods

A randomized, triple-blind, multicenter clinical trial was conducted between March 2010 and June 2011. Women with a single gestation (n = 200) were randomized to receive a titrated oral misoprostol solution (initial misoprostol dose 20 渭g/hour; dose increased by 20 渭g/hour every 6 hours up to 80 渭g/hour for a maximum of 48 doses) or vaginal misoprostol tablets (25 渭g of misoprostol every 6 hours for a maximum of 8 doses). Risk ratios (RR) and 95% confidence intervals (CIs) were calculated for maternal and perinatal outcomes.

Results

The frequencies of vaginal delivery not achieved within 12 hours (RR 0.87; 95% CI, 0.62-1.22) and within 24 hours (RR 1.11; 95% CI, 0.83-1.49) were similar in the 2 groups. No differences were found in terms of uterine hyperstimulation, unfavorable cervix at 12 and 24 hours, oxytocin augmentation, tachysystole, epidural analgesia, adverse effects, and perinatal outcome. Approximately 70% of the women preferred the oral solution.

Conclusion

A titrated oral misoprostol solution was as effective and safe for labor induction as vaginal misoprostol tablets.

ClinicalTrial.gov: NCT00 992524