Randomized comparison of oral misoprostol and oxytocin for labor inductionin term prelabor membrane rupture

Objectives: To compare labor induction intervals between oral misoprostol a nd intravenous oxytocin in women who present at term with premature rupture of membranes. Methods: One hundred eight women were randomly assigned to misoprostol 50 m u g orally every 4 hours as needed or intravenous oxytocin. The primary out come measure was time from induction to vaginal delivery. Sample size was c alculated using a two-tailed cy of 0.05 and power of 80%. Results: Baseline demographic data, including maternal age, gestation, pari ty, Bishop score, birth weight, and group B streptococcal status, were simi lar. The mean time +/- standard deviation to vaginal birth with oral misopr ostol was 720 +/- 382 minutes compared with 501 +/- 389 minutes with oxytoc in (P =.007). The durations of the first, second, and third stages of labor were similar. There were no differences in maternal secondary outcomes, in cluding cesarean birth (eight and seven, respectively), infection, maternal satisfaction with labor, epidural use, perineal trauma, manual placental r emoval, or gastrointestinal side effects. Neonatal outcomes including cord pH, Apgar scores, infection, and admission to neonatal intensive care unit were not different. Conclusion: Although labor induction with oral misoprostol was effective, o xytocin resulted in a shorter induction-to-delivery interval. Active labor intervals and other maternal and neonatal outcomes were similar. (Obstet Gy necol 1999; 94:994-9. (C) 1999 by The American College of Obstetricians and Gynecologists.).