Extra amniotic misoprostol as a cervical ripening agent: a double blind clinical trial

ABSTRACT

Induction of labor is often necessary and patients with a ripe cervix are more easily induced. The drug of choice for ripening the cervix is dinoprostone prostaglandin E2 (PGE2). This is very expensive and often not available. We decided to use a cheaper prostaglandin misoprostol (PGE1). This was compared to placebo in a double blind clinical trial. The study was done in 45 women in the 3rd trimester who required induction of labor but had an unripe cervix. 100ug of misoprostol was the dose used. The results showed that misoprostol was superior to placebo. Mean change in Bishop Score 5.3 for misoprostol compared to 1.5 with placebo (p<0.001). Mean time from insertion to delivery 43 hours in the placebo group compared to 15.6 hours in misoprostol group (p<0.001). Need for oxytocin was significantly less with misoprostol 29 percent vs 65 percent (p<0.02). there was no difference in outcome in terms of complications foetal Apgar Score and type of delivery. (AU)