Oral misoprostol for induction of labor at term: a randomized controlled trial of hourly titrated and 2 hourly static oral misoprostol solution

Abstract

Background: Misoprostol has been shown to be effective in induction of labor (IOL) with different dosages and routes of administration.

Objectives: This study compared the efficacy and safety of hourly titrated and 2-hourly static low dose oral misoprostol for IOL in Ekiti State University Teaching Hospital, Ado-Ekiti.

Methods: One hundred fifty women with singleton pregnancy at term admitted for IOL were randomized into the two groups. Oxytocin augmentation was done as necessary. The primary outcome is rate of vaginal delivery within 24 hours. Data were analyzed using SPSS.

Results: Vaginal delivery was achieved within 24 hours in 40 (67.8%) women who received hourly titrated-doses oral misoprostol and 42 (70.0%) women who received 2-hourly static-dose of oral misoprostol, p > .05. The rate of vaginal delivery, oxytocin augmentation, induction delivery time and cesarean section rate were similar in both groups, p > .05. Occurrence of uterine hyperactivity did not differ significantly among the women (p > .05) and no cases of uterine rupture were recorded. There were no adverse neonatal outcomes.

Conclusions: The hourly titrated oral misoprostol is as effective and safe as the 2-hourly static oral misoprostol for IOL. Both can be utilized in IOL without the fear of adverse outcomes.

Keywords:

• Hourly titrated-dose
• induction of labor
• oral misoprostol
• randomized controlled trial
• static dose

Acknowledgments

The authors wished to acknowledge all women that participated in the study, the antenatal and labor ward staff that monitored the women while on admission. We also acknowledged the Specialist Registrars involved in the randomization of the participants and the Senior Registrars who supervised the labor management.

Disclosure statement

No potential conflict of interest was reported by the authors.