Title: Comparison of vaginal and oral misoprostol, for the induction of labour in women with intra-uterine foetal death.

POPLINE Document Number: 195458

Author(s):

Nyende L
Towobola OA
Mabina MH

Source citation:

East African Medical Journal, 2004 Apr;81(4):179-182.

Abstract:

Objective: To compare the efficacy of vaginal and oral misoprostol for the induction of labour in women with intra-uterine foetal death (IUFD). Design: A prospective randomised clinical trial, comparing 200µg oral and 200µg vaginal misoprostol, six hourly for a minimum of four doses for the induction of labour in women with IUFD. Setting: Ga-Rankuwa hospital (Department of Obstetrics and Gynaecology), Pretoria, South Africa. It is a tertiary institution serving predominantly black indigenous population. Main outcome measures: The primary outcome measure was the induction to delivery time, and secondary outcome measures were the number of patients requiring augmentation with oxytocin and all complications were noted. Results: Twenty women were randomised to the vaginal route and 18 to the oral route. The induction to delivery time was shorter with vaginal misoprostol (13.5 +/- 8.3 hrs) compared to oral misoprostol (21.4 +/- 13.9 hrs; p< 0.05). There was no significant difference in the amount of misoprostol needed to achieve successful induction in the two groups. More women (10/18) who received oral misoprostol required oxytocin augmentation to complete the induction of labour compared with 4/20 women in the vaginal group (p<0.05; Odds Ratio 2.8; 95% CI 1.36 - 4.24). There were no cases of failed induction. The systemic side effects (shivering, diarrhoea, vomiting and pyrexia) were more common with oral misoprostol (44.5%) compared to vaginal misoprostol (20%). This difference gives an overall Odds Ratio of 2.2 at 95% CI of 1.6-2.8(p<0.05). Conclusion: Vaginal misoprostol achieved successful induction of labour in women with IUFD in a shorter time than oral misoprostol with significantly less side effects. (author's)

Keywords:

South Africa
Research Report
Clinical Trials
Clients
Misoprostol
Administration and Dosage
Abortion
Fetal Death
Side Effects
Africa, Southern
Africa, Sub Saharan
Africa
Developing Countries
Clinical Research
Research Methodology
Program Activities
Programs
Organization and Administration
Prostaglandins, Synthetic
Prostaglandins
Endocrine System
Physiology
Biology
Drugs
Treatment
Fertility Control, Postconception
Family Planning
Mortality
Population Dynamics
Demographic Factors
Population