ORAL OR VAGINAL MISOPROSTOL ADMINISTRATION FOR INDUCTION OF LABOR - ARANDOMIZED, DOUBLE-BLIND TRIAL

Objective: To compare the efficacy and vaginal birth intervals after i ntravaginal or oral misoprostol for labor induction. Methods: One hund red seventy-eight women were randomized to one of two double-blind gro ups: 1) oral misoprostol 200 mu g and one-half tablet placebo intravag inal or 2) oral placebo tablet and one-half tablet of a 100-mu g misop rostol intravaginal (dose 50 mu g). Doses were repeated every 6 hours until labor was established (maximum of three doses). Results: Ninety- three subjects were assigned to oral misoprostol and 85 to intravagina l administration, Oral administration was accompanied by significantly shorter intervals to the onset of uterine contractility (133 +/- 78 m inutes versus 168 +/- 93, P < .01) but a higher incidence of abnormal uterine contractile activity (tachysystole 38.7% versus 20.0%, P < .01 ; hyperstimulation syndrome 44.1% versus 21.2%, P < .01). No adverse m aternal or neonatal outcomes were noted, nor were there differences in cesarean delivery rates or total lengths of labor. Conclusion: Oral a dministration of 200 mu g misoprostol has similar efficacy to intravag inal administration of 50 mu g but is associated with more frequent ab normal uterine contractility. (Obstet Gynecol 1998;92:810-3. (C) 1998 by The American College of Obstetricians and Gynecologists.)