Sublingual compared with oral misoprostol in term labour induction: a randomised controlled trial

Shetty, Ashalatha; Mackie, Lisa; Danielian, Peter; Rice, Pat; Templeton, Allan

doi:10.1111/j.1471-0528.2002.01459.x

Cited by 46 publications

(18 citation statements)

References 13 publications

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“…Overall, rates of uterine hyperstimulation syndrome were not higher in this study (7.1%) than in other clinical trials of 50 μg of sublingual misoprostol for labour induction (5–8%) 15,16 . The incidence of hyperstimulation syndrome in two recent studies of sublingual misoprostol 50 μg was only 1.6–2% 11,12 . Despite the lower hyperstimulation syndrome rate, the incidence of caesarean section for fetal distress and instrumental vaginal delivery in both the above mentioned studies was higher than in the present study (6.0 and 22%; 11 and 27% versus 10 and 7.1%, respectively) 11,12 .…”

Section: Discussioncontrasting

confidence: 84%

“…The objective of this study was to compare the efficacy and safety of 50 μg of sublingual misoprostol with vaginal misoprostol in its currently recommended dose of 25 μg administered at 4‐hour intervals for labour induction at term. We decided to use the 50‐μg sublingual misoprostol dose because this dosage seems to be effective and safe in previous studies when compared with oral misoprostol 11,12 …”

Section: Introductionmentioning

confidence: 99%

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Sublingual compared with vaginal misoprostol for labour induction at term: a randomised controlled trial

Bartusevičius¹,

Barčaitė²,

Krikštolaitis

et al. 2006

BJOG

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Objective To compare the efficacy and safety of 50 mg of sublingual misoprostol with 25 mg of vaginal misoprostol administered for labour induction at term.Design Double-blinded, randomised controlled trial.Setting University Hospital, Kaunas, Lithuania.Sample A total of 140 women at term with indications for labour induction.Methods Women were randomised to receive either 50 mg of sublingual misoprostol with vaginal placebo (n = 70) or sublingual placebo with 25 mg of vaginal misoprostol (n = 70) every 4 hours (maximum six doses).Main outcome measures The number of women delivering vaginally within 24 hours of labour induction.Results Fifty-eight women (83%) in the sublingual misoprostol group and 53 (76%) in the vaginal misoprostol group delivered vaginally within 24 hours [relative risk (RR) 1.1, 95% confidential interval (CI) 0.9-1.3]. However, the induction to vaginal delivery time was significantly shorter in the sublingual group (15.0 ± 3.7 hours) compared with the vaginal group (16.7 ± 4.1 hours, P = 0.03). The incidence of tachysystole was more than three-fold higher in the sublingual than in the vaginal group (14 versus 4.3%; RR 3.3, 95% CI 0.9-11.6), but this was not statistically significant. There were no significant differences in the incidence of hypertonus or hyperstimulation syndrome, mode of delivery, interventions for fetal distress or neonatal outcomes between the two groups.Conclusion A 50 mg of sublingual misoprostol 4 hourly for labour induction at term seems to have similar efficacy as 25 mg of vaginal misoprostol. Further studies on safety with larger numbers of women need to be conducted before routine sublingual misoprostol use in this setting.

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Section: Discussioncontrasting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Sublingual compared with vaginal misoprostol for labour induction at term: a randomised controlled trial

Bartusevičius¹,

Barčaitė²,

Krikštolaitis

et al. 2006

BJOG

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“…Three studies were identified that compared sublingual or buccal with otherwise administered misoprostol [19–21]. One study ( n = 157) compared buccal (200 μg) with vaginal (50 μg) misoprostol administered six hourly [19].…”

Section: Resultsmentioning

confidence: 99%

“…None of these differences were statistically significant, nor were any other outcome variables. Two studies ( n = 350) compared 50 μg of sublingual with 50 and 100 μg of oral misoprostol administered every 4 h [20,21]. When the same dosage was used by both routes, the sublingual misoprostol appeared associated with less failure to achieve vaginal delivery after 24 h (24% versus 38%; OR 0.52, 95% CI 0.22–1.22), less oxytocin augmentation (34% versus 46%; OR 0.60, 95% CI 0.27–1.36) and less cesarean section (16% versus 30%; OR 0.44, 95% CI 0.17–1.17), but none of these differences were statistically significant.…”

Section: Resultsmentioning

confidence: 99%

Oral, vaginal and sublingual misoprostol for induction of labor

Bartusevičius

Barčaitė

Nadišauskienė

2005

Intl J Gynecology & Obste

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“…8 11 However, there are multiple studies supporting efficacy and safety of sublingually administered misoprostol when compared with the vaginal and oral routes for IOL. 12 13 14 15 16 …”

Section: Discussionmentioning

confidence: 99%

Survey of Provider Preferences Regarding the Route of Misoprostol for Induction of Labor at Term

Towns

Quinney

Pierson

et al. 2017

AJP Rep

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Objective To survey obstetrical provider preferences regarding use of misoprostol for induction of labor (IOL). Methods An anonymous 25-question survey was distributed at an American College of Obstetricians and Gynecologists (ACOG) joint District V and VII Meeting in 2014 to obstetrics providers. The same survey was sent electronically to local providers. A separate survey was emailed to the labor and delivery nurses at two of the teaching hospitals in Indianapolis. The surveys queried provider demographics, dosing practice for misoprostol, opinions regarding different dosing strategies, and instructions on buccal administration. Results A total of 113 (46.5%) providers responded. Of these, 92.9% used misoprostol for IOL, 73% preferred the vaginal route, 20% preferred buccal administration, and 7% oral administration. Only resident physician and midwife providers endorsed buccal route preference. Being a midwife independently predicted a preference for using buccal misoprostol (odds ratio [OR]: 125.8, 95% confidence interval [CI]: 7.9–1992.3). Additionally, 44 nurses completed the survey regarding administration techniques of buccal misoprostol. Also, 54.5% of nurses correctly instructed their patients on buccal administration techniques. Conclusion Although not extensively studied, one-fifth of providers, particularly nurse midwives, prefer buccal administration of misoprostol for IOL. The majority of nurses correctly administered buccal misoprostol. There may be a need for further study and education about buccal administration of misoprostol for IOL.

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Sublingual compared with oral misoprostol in term labour induction: a randomised controlled trial

Abstract: Fifty micrograms of sublingual misoprostol every four hours has the same efficacy and safety profile as compared with 100 microg orally, but the oral route might be preferred by women.

Cited by 46 publications

References 13 publications

Sublingual compared with vaginal misoprostol for labour induction at term: a randomised controlled trial

Sublingual compared with vaginal misoprostol for labour induction at term: a randomised controlled trial

Oral, vaginal and sublingual misoprostol for induction of labor

Survey of Provider Preferences Regarding the Route of Misoprostol for Induction of Labor at Term

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