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Slow-release vaginal insert of misoprostol vs orally administrated solution of misoprostol for the induction of labour in primiparous term pregnant women: A randomized controlled trial

BJOG: An International Journal of Obstetrics and Gynaecology May 23, 2019

Wallström T, et al. - In this open-label, randomized controlled trial, the World Health Organization recommended orally administrated dosage of misoprostol (25 μg) was compared with a vaginal slow-release (7 μg/hours) insert of misoprostol with respect to the time from induction to delivery and safety of the method. Researchers randomized 196 primiparous women with singletons in a cephalic presentation at ≥37 weeks of gestation and with a Bishop score of ≤4, to an oral solution of misoprostol (Cytotec n = 99) or vaginal slow-release misoprostol [Misodel n = 97]. Outcomes revealed no shorter time from induction to vaginal-delivery but a higher risk for hyperstimulation and fetal distress in vaginal delivery after induction of labor with slow-release misoprostol vs oral misoprostol solution. No differences in mode of delivery or neonatal outcome were evident.
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