A comparison of the efficacy and safety of repetitive hourly dose of oral misoprostol and two hourly dose oral regimens for cervical ripening and labor induction: A R.C.T

Abstract

Background Labor induction most frequently conducted through interventional procedures, and their use has been increasing in the past several decades. In a survey by the National Center for Health Statistics the rate of labor induction was noted to have increased from 9.5% in 1991 to 22.5% in 2006. This randomized controlled trial was conducted at Ain Shams University Maternity Hospital (pre-labour ward) in the period between January 2019 and January 2020. Patients and Methods This study was conducted on 150 pregnant women attending Ain Shams University Hospital outpatient clinic, they were classified according to the indication for labor induction into 2 groups, high risk group and low risk group. Results that there was no statistically significant difference between groups according to baseline characteristics, indication of induction and need for oxytocin. Regarding medications side effect and maternal outcomes, our results showed that there was statistically significant difference between groups according to pyrexia. Regarding mode of delivery, our results showed that there was no statistically significant difference between groups. Regarding no. of req. doses and duration of delivery, our results showed that there was statistically significant difference between groups according to no. of req. doses and duration of delivery (hrs) and total dose of misoprostol (µg), more in group I (hourly dose) than II (2 hours dose). Regarding fetal outcomes (Apgar score at 1 and 5 min, birth weight (kg), meconium staining, NICU admission), our results showed that there was no statistically significant difference between 2 groups. Conclusion The repetitive hourly dose of misoprostol solution (10 μg -10 mL- oral misoprostol administered hourly up to12 doses) has similar efficacy as oral misoprostol solution every 2 hours (20 μg -20 mL- administered every 2 hours up to 6 doses) but with more side effects.