Misoprostol for induction of labour: The Hyderabad experience

Abstract

OBJECTIVES: To determine the safety and efficacy of Misoprostol for induction of labour in a secondary care set up. DESIGN: Quasi experimental study. SETTING: Labour ward at Aga Khan Maternal and Child Care Center, Hyderabad - Sindh, Pakistan from September 2005 to May 2006. METHODS: Forty women having singleton pregnancy, with indication for induction of labour were enrolled for this study. After a verbal consent, 100 mgm of Misoprostol (1/2 Tablet Cytotec, Searle & Co. Chicago) was inserted in posterior vaginal fornix and repeated every 6 hourly for a maximum of 3 doses or initiation of active labour. Induction failure, caesarean delivery, uterine hyperstimulation and rupture, and the neonatal outcome were main outcome measures. Data were collected through a pre-designed proforma and analyzed through SPSS software version 10.0. RESULTS: Labour was successfully completed in 35(87.5%) women, even when Bishop's score was <4. Induction failure was noted in 2(5%) women, however, no case of uterine rupture or severe birth asphyxia was found. Out of these 35 women, 12(31.6%) delivered within 7-8 hours of initiation of labour. Labour was initiated with 2 doses of 100 mgm Misoprostol in 17(42.5%) cases. CONCLUSION: Misoprostol seems to be a safe and effective agent for induction of labour. However, these results should be interpretted with caution because of limited number of women in this series.