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. 2017:2017:6840592.
doi: 10.1155/2017/6840592. Epub 2017 Sep 18.

Labor Induction with Orally Administrated Misoprostol: A Retrospective Cohort Study

Tove Wallstrom  1 , Hans Jarnbert-Pettersson  1 , David Stenson  1 , Helena Akerud  2 , Elisabeth Darj  2   3 , Kristina Gemzell-Danielsson  4 , Eva Wiberg-Itzel  1
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Labor Induction with Orally Administrated Misoprostol: A Retrospective Cohort Study

Tove Wallstrom et al. Biomed Res Int. 2017.

Abstract

Introduction: One great challenge in obstetric care is labor inductions. Misoprostol has advantages in being cheap and stable at room temperature and available in resource-poor settings.

Material and methods: Retrospective cohort study of 4002 singleton pregnancies with a gestational age ≥34 w at Sodersjukhuset, Stockholm, during 2009-2010 and 2012-2013. Previously used methods of labor induction were compared with misoprostol given as a solution to drink, every second hour. Main outcome is as follows: Cesarean Section (CS) rate, acid-base status in cord blood, Apgar score < 7,5', active time of labor, and blood loss > 1500 ml (PPH).

Results: The proportion of CS decreased from 26% to 17% when orally given solution of misoprostol was introduced at the clinic (p < 0.001). No significant difference in the frequency of low Apgar score (p = 0.3), low aPh in cord blood (p = 0.1), or PPH (p = 0.4) between the different methods of induction was studied. After adjustment for different risk factor for CS the only method of induction which was associated with CS was dinoproston⁎⁎ (Propess®) (aor = 2.9 (1.6-5.2)).

Conclusion: Induction of labor with misoprostol, given as an oral solution to drink every second hour, gives a low rate of CS, without affecting maternal or fetal outcome.

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Flow chart of study design.
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