LABOR INDUCTION WITH INTRAVAGINAL MISOPROSTOL IN TERM PREMATURE RUPTURE OF MEMBRANES - A RANDOMIZED STUDY

Objective: To evaluate the safety and clinical effectiveness of intrav aginal misoprostol, a synthetic prostaglandin E-1 analogue, for labor induction in gravidas with premature rupture of membranes (FROM) at te rm. Methods: One hundred forty-one pregnant women with term FROM were assigned randomly to one of two induction groups: 1) intravaginal miso prostol or 2) intravenous oxytocin by continuous infusion. Results: Se venty subjects were allocated to the misoprostol group and 71 to the o xytocin group. The mean (+/- standard deviation) interval from inducti on to delivery was significantly shorter in the misoprostol group (416 +/- 276 compared with 539 +/- 372 minutes; P =.04). In 85.7% of patie nts in the misoprostol group, only one dose was required. Intrapartum complication rates, mode of delivery, and neonatal or maternal adverse event rates were similar in the two treatment groups. Uterine tachysy stole occurred more frequently with misoprostol than with oxytocin (28 .6% compared with 14.0%; P <.04). Conclusion: Intravaginal administrat ion of misoprostol induces labor safely and effectively in patients wi th PROM at term. (C) 1997 by The American College of Obstetricians and Gynecologists.