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.