A comparison of orally administered misoprostol to intravenous oxytocin for labor induction in women with favorable cervical examinations

Deborah A. Wing, Michael J. Fassett, Cristiane Guberman, Susan Tran, Antigone Parrish, Debra Guinn

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective The purpose of this study was to compare orally administered misoprostol with intravenous oxytocin infusion for labor induction in women with favorable cervical examinations (defined as a Bishop score of 6 or more). Study design One hundred ninety-eight women with indications for labor induction and favorable cervical examinations were assigned randomly to receive oral misoprostol or oxytocin induction. Misoprostol, 100 mg, was administered every 4 hours up to 6 doses, or intravenous oxytocin was administered by standardized protocol. Results One hundred ten (55.6%) women received misoprostol; 88 (44.4%) received intravenous oxytocin. There was no statistically significant difference in the average interval from start of induction to vaginal delivery, being longer in the misoprostol group (789.4 ± 510.2 minutes) than in the oxytocin group (654.0 ± 338.2 minutes, P=.19, log-transformed data). Two women had tachysystole develop in each treatment group. More women in the misoprostol group experienced hyperstimulation (7/110, 6.4%) than in the oxytocin group (0/88, P=.02, Fisher exact test). Nine (8.1%) misoprostol-treated women and 8 (9.1%) oxytocin-treated women underwent cesarean deliveries (P=.82). There was a presumed uterine rupture in a misoprostol-treated multipara women. There were no statistically significant differences in neonatal outcomes between the groups. Conclusion Oral misoprostol offers no benefit over intravenous oxytocin for labor induction in women with favorable cervical examinations. It is associated with a higher likelihood of uterine hyperstimulation and may increase the risk of uterine rupture.

Original languageEnglish (US)
Pages (from-to)1689-1696
Number of pages8
JournalAmerican Journal of Obstetrics and Gynecology
Volume190
Issue number6
DOIs
StatePublished - Jun 2004
Externally publishedYes

Fingerprint

Induced Labor
Misoprostol
Oxytocin
Uterine Rupture
Intravenous Infusions

Keywords

  • Hyperstimulation
  • Labor induction
  • Oral misoprostol

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

A comparison of orally administered misoprostol to intravenous oxytocin for labor induction in women with favorable cervical examinations. / Wing, Deborah A.; Fassett, Michael J.; Guberman, Cristiane; Tran, Susan; Parrish, Antigone; Guinn, Debra.

In: American Journal of Obstetrics and Gynecology, Vol. 190, No. 6, 06.2004, p. 1689-1696.

Research output: Contribution to journalArticle

Wing, Deborah A. ; Fassett, Michael J. ; Guberman, Cristiane ; Tran, Susan ; Parrish, Antigone ; Guinn, Debra. / A comparison of orally administered misoprostol to intravenous oxytocin for labor induction in women with favorable cervical examinations. In: American Journal of Obstetrics and Gynecology. 2004 ; Vol. 190, No. 6. pp. 1689-1696.
@article{ee23f7617d3649f0bf25e7de1973530c,
title = "A comparison of orally administered misoprostol to intravenous oxytocin for labor induction in women with favorable cervical examinations",
abstract = "Objective The purpose of this study was to compare orally administered misoprostol with intravenous oxytocin infusion for labor induction in women with favorable cervical examinations (defined as a Bishop score of 6 or more). Study design One hundred ninety-eight women with indications for labor induction and favorable cervical examinations were assigned randomly to receive oral misoprostol or oxytocin induction. Misoprostol, 100 mg, was administered every 4 hours up to 6 doses, or intravenous oxytocin was administered by standardized protocol. Results One hundred ten (55.6{\%}) women received misoprostol; 88 (44.4{\%}) received intravenous oxytocin. There was no statistically significant difference in the average interval from start of induction to vaginal delivery, being longer in the misoprostol group (789.4 ± 510.2 minutes) than in the oxytocin group (654.0 ± 338.2 minutes, P=.19, log-transformed data). Two women had tachysystole develop in each treatment group. More women in the misoprostol group experienced hyperstimulation (7/110, 6.4{\%}) than in the oxytocin group (0/88, P=.02, Fisher exact test). Nine (8.1{\%}) misoprostol-treated women and 8 (9.1{\%}) oxytocin-treated women underwent cesarean deliveries (P=.82). There was a presumed uterine rupture in a misoprostol-treated multipara women. There were no statistically significant differences in neonatal outcomes between the groups. Conclusion Oral misoprostol offers no benefit over intravenous oxytocin for labor induction in women with favorable cervical examinations. It is associated with a higher likelihood of uterine hyperstimulation and may increase the risk of uterine rupture.",
keywords = "Hyperstimulation, Labor induction, Oral misoprostol",
author = "Wing, {Deborah A.} and Fassett, {Michael J.} and Cristiane Guberman and Susan Tran and Antigone Parrish and Debra Guinn",
year = "2004",
month = "6",
doi = "10.1016/j.ajog.2004.02.045",
language = "English (US)",
volume = "190",
pages = "1689--1696",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - A comparison of orally administered misoprostol to intravenous oxytocin for labor induction in women with favorable cervical examinations

AU - Wing, Deborah A.

AU - Fassett, Michael J.

AU - Guberman, Cristiane

AU - Tran, Susan

AU - Parrish, Antigone

AU - Guinn, Debra

PY - 2004/6

Y1 - 2004/6

N2 - Objective The purpose of this study was to compare orally administered misoprostol with intravenous oxytocin infusion for labor induction in women with favorable cervical examinations (defined as a Bishop score of 6 or more). Study design One hundred ninety-eight women with indications for labor induction and favorable cervical examinations were assigned randomly to receive oral misoprostol or oxytocin induction. Misoprostol, 100 mg, was administered every 4 hours up to 6 doses, or intravenous oxytocin was administered by standardized protocol. Results One hundred ten (55.6%) women received misoprostol; 88 (44.4%) received intravenous oxytocin. There was no statistically significant difference in the average interval from start of induction to vaginal delivery, being longer in the misoprostol group (789.4 ± 510.2 minutes) than in the oxytocin group (654.0 ± 338.2 minutes, P=.19, log-transformed data). Two women had tachysystole develop in each treatment group. More women in the misoprostol group experienced hyperstimulation (7/110, 6.4%) than in the oxytocin group (0/88, P=.02, Fisher exact test). Nine (8.1%) misoprostol-treated women and 8 (9.1%) oxytocin-treated women underwent cesarean deliveries (P=.82). There was a presumed uterine rupture in a misoprostol-treated multipara women. There were no statistically significant differences in neonatal outcomes between the groups. Conclusion Oral misoprostol offers no benefit over intravenous oxytocin for labor induction in women with favorable cervical examinations. It is associated with a higher likelihood of uterine hyperstimulation and may increase the risk of uterine rupture.

AB - Objective The purpose of this study was to compare orally administered misoprostol with intravenous oxytocin infusion for labor induction in women with favorable cervical examinations (defined as a Bishop score of 6 or more). Study design One hundred ninety-eight women with indications for labor induction and favorable cervical examinations were assigned randomly to receive oral misoprostol or oxytocin induction. Misoprostol, 100 mg, was administered every 4 hours up to 6 doses, or intravenous oxytocin was administered by standardized protocol. Results One hundred ten (55.6%) women received misoprostol; 88 (44.4%) received intravenous oxytocin. There was no statistically significant difference in the average interval from start of induction to vaginal delivery, being longer in the misoprostol group (789.4 ± 510.2 minutes) than in the oxytocin group (654.0 ± 338.2 minutes, P=.19, log-transformed data). Two women had tachysystole develop in each treatment group. More women in the misoprostol group experienced hyperstimulation (7/110, 6.4%) than in the oxytocin group (0/88, P=.02, Fisher exact test). Nine (8.1%) misoprostol-treated women and 8 (9.1%) oxytocin-treated women underwent cesarean deliveries (P=.82). There was a presumed uterine rupture in a misoprostol-treated multipara women. There were no statistically significant differences in neonatal outcomes between the groups. Conclusion Oral misoprostol offers no benefit over intravenous oxytocin for labor induction in women with favorable cervical examinations. It is associated with a higher likelihood of uterine hyperstimulation and may increase the risk of uterine rupture.

KW - Hyperstimulation

KW - Labor induction

KW - Oral misoprostol

UR - http://www.scopus.com/inward/record.url?scp=3442901942&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3442901942&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2004.02.045

DO - 10.1016/j.ajog.2004.02.045

M3 - Article

C2 - 15284771

AN - SCOPUS:3442901942

VL - 190

SP - 1689

EP - 1696

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 6

ER -