Haas DM, et al. - Researchers designed the IMPROVE trial, an IRB-approved, triple-masked, placebo-controlled randomized non-inferiority trial, to evaluate vaginal vs buccal misoprostol for women undergoing labor induction at term regarding efficacy and safety. Enrollment of 319 women was done; of these 300 were available for analysis; 25 mcg (1st dose), then 50 mcg (subsequent doses) of misoprostol was administered to 152 by vaginal route and to 148 by buccal route. Non-inferiority was demonstrated in this work. Vaginal misoprostol led to a higher rate of vaginal deliveries, more rapid vaginal delivery, and fewer cesareans for fetal issues, suggesting its possible superiority to buccal misoprostol for cervical ripening at term.