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A randomized comparison between intravaginal misoprostol and prostaglandin E2 for labor induction

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Abstract

Objective

The aim of this randomized study was to compare the effectiveness, safety, and side effects of 6 h vaginal misoprostol versus vaginal prostaglandin E2 (PGE2) for labor induction.

Study design

Fifty microgram of misoprostol was given intravaginally in the misoprostol group (204 women), and 3 mg PGE2 was given intravaginally in the PGE2 group (211 women). In both groups, the dose was repeated every 6 h for a maximum of three doses, until active labor was achieved. Artificial rupture of membranes and oxytocin infusion was used during labor in both groups where it was indicated.

Results

The mean interval from the institution of labor induction to delivery was 11.3 ± 8.6 h for the misoprostol group, and 15.7 ± 9.3 h for PGE2 group (P < 0.05). In the misoprostol group, oxytocin was used less frequently, but there was a higher prevalence of tachysystole. No statistically significant differences were observed between the two groups as regard abnormal patterns of fetal heart rate, the mode of delivery, and the need for neonatal intervention.

Conclusion

In conclusion, the intravaginal administration of 50 μg misoprostol at 6 h interval (maximum three doses) is comparable in safety, but more effective for induction of labor than 3 mg intravaginal PGE2.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Crete, Heraklion, Greece

    S. Sifakis, E. Angelakis, E. Avgoustinakis, N. Mantas, O. Koukoura, E. Vardaki & E. Koumantakis

  2. Department of Hygiene and Epidemiology, University of Athens, Athens, Greece

    Y. Fragouli

  3. 228 Oulaf Palme Str, Heraklion, 71410, Crete, Greece

    S. Sifakis

Authors
  1. S. Sifakis
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  2. E. Angelakis
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  3. E. Avgoustinakis
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  4. Y. Fragouli
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  5. N. Mantas
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  6. O. Koukoura
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  7. E. Vardaki
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  8. E. Koumantakis
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Correspondence to S. Sifakis.

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Sifakis, S., Angelakis, E., Avgoustinakis, E. et al. A randomized comparison between intravaginal misoprostol and prostaglandin E2 for labor induction. Arch Gynecol Obstet 275, 263–267 (2007). https://doi.org/10.1007/s00404-006-0258-4

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  • DOI: https://doi.org/10.1007/s00404-006-0258-4

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