Majallah-i Dānishgāh-i ̒Ulūm-i Pizishkī-i Bābul (May 2012)

Oral Misoprostol with Oxytocin versus Oxytocin Alone for Labor Induction in Pre-Labor Rupture of Membranes (PROM) at Term Pregnancy

  • SH Yazdani,
  • Z Bouzari,
  • S Farahi,
  • A Monadi Tabary

Journal volume & issue
Vol. 14, no. 3
pp. 7 – 12

Abstract

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BACKGROUND AND OBJECTIVE: There are different methods of labor induction in PROM at term pregnancy including oxytocin and some prostaglandin such as misoprostol. Misoprostol has different effects on the induction of labor in PROM with different methods and dosages. The aim of this study was to compare the efficacy of oral misoprostol with oxytocin and oxytocin alone in induction of labor at term pregnant women with premature rupture of membranes.METHODS: This clinical trial study was performed on 99 term pregnant women with PROM who in the first 4 hours after PROM for delivery were admitted in Ayatollah Roohani and Shahid Beheshti hospitals of Babol, Iran. They were randomly assigned in a double-blinded manner to two groups. Misoprostol 50µg in two doses was administered 4 and 8 hours after rupture of membranes to one group (49 patients) and placebo was administered up to two doses to the other group (50 patients). When labor did not occur after 12 hours of rupture of membrane, oxytocin was administered for induction of the labor in both groups. Then type of delivery, cause of cesarean, duration between PROM until delivery, appropriate uterine contraction and maternal complications such as chorioamnionitis and uterine hyperstimulation were recorded and compared.FINDINGS: Average duration between rupture of membranes and delivery was similar to each other in two groups (14.3±3.4 hours in misoprostol group in compare with 15.6±3.29 hours in placebo group) (p=0.061). Average duration between rupture of membranes and uterine contraction was significantly shorter in misoprostol group (8.06±3.8 hours in compare with 9.8±3.9 hours) (p=0.027). The rate of vaginal delivery in misoprostol group was 30 (61.2%) and in placebo group was 24 (48%), and the rate of cesarean delivery in misoprostol group was 19 (38.8%) and in placebo group was 26 (52%), that there was not a significant difference (p=0.13). Maternal complications were not different in two groups.CONCLUSION: Results of this study showed that oral misoprostol 50µg in comparison with placebo could start uterine contraction without the increase of maternal and neonatal complications.

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