Use of misoprostol for cervical ripening

Background. Misoprostol, the prostaglandin E, analog, is increasingly used for cervical ripening and induction of labor. We evaluated our experience w ith misoprostol in an open-label setting. Methods. Patients were selected for cervical ripening based on clinical pro file. At 3 cm cervical dilation, misoprostol was discontinued and other mea ns of labor augmentation were used. Over 13 months, 470 inductions of labor occurred, and 455 charts were available; 254 patients (56%) received misop rostol for cervical ripening,and 144 (32%) received dinoprostone (prostagla ndin E-2). Results. With misoprostol, mean time from beginning of contractions until d elivery was 7 hours, 30 minutes; vaginal birth occurred in 85% of cases, an d spontaneous labor occurred in 38%. Hyperstimulation occurred in 4 cases ( 1.6%) and precipitate labor in 7 (3%). All infants were discharged in excel lent condition; one had a 5-minute Apgar score <7, and 33 (13%) had meconiu m, none wit aspiration. Twenty-three patients who had had a previous cesare an section received misoprostol and delivered vaginally. Conclusion. Misoprostol was found to be a safe and effective agent for cerv ical ripening as part of labor induction.