HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wolf, S. B. Articles by Kaunitz, A. M. Search for Related Content PubMed PubMed Citation Articles by Wolf, S. B. Articles by Kaunitz, A. M. Related Collections Labor and operative obstetrics

Sublingual Misoprostol for Labor Induction: A Randomized Clinical Trial

From the Department of Obstetrics and Gynecology, University of Florida Health Sciences Center Jacksonville, Jacksonville, Florida.

OBJECTIVE: To compare the effectiveness of 50 µg compared with 100 µg of repetitive misoprostol dosages administered sublingually for labor induction.

METHODS: Two hundred twelve women who presented with an indication for cervical ripening and labor induction were randomly assigned to 50 µg or 100 µg of misoprostol tablets administered sublingually with double masking of treatment group dose allocation. The primary outcome was the interval from start of induction to vaginal delivery.

RESULTS: Among the 203 evaluable participants, 102 were randomly assigned to the 50-µg group and 101 to the 100-µg group. The proportion of patients who delivered vaginally in less than 12 hours and less than 24 hours was significantly higher in the 100-µg group: 28% and 63% in the 100-µg group compared with 15% and 36% in the 50-µg group, respectively (P = .01 and P = .001). The incidence of tachysystole was significantly higher in the 100-µg group (P = .02). The incidence of hyperstimulation syndrome was higher in the 100-µg group, but not statistically significant (P = .46). With respect to the proportion of patients delivered after a single dose, mode of delivery, and perinatal outcome, no significant differences between treatment groups were observed. Regarding the need for oxytocin augmentation, 61% required augmentation in the 100-µg group compared with 81% in the 50-µg group (P = .002).

CONCLUSION: One hundred micrograms of sublingual misoprostol is more effective than 50 µg of sublingual misoprostol, but is associated with a higher incidence of tachysystole and uterine hyperstimulation syndrome.

LEVEL OF EVIDENCE: I