Misoprostol for induction of labor in women with severe preeclampsia at or near term.

OBJECTIVE

To examine the misoprostol efficacy and safety in induction of labor of women with severe preeclampsia at or near term when the cervix is unfavorable.

METHODS

A prospective comparative study was conducted in Al-Thawara General Hospital Sana'a , Yemen, from June 2009 to June 2010. One hundred and thirteen women met the inclusion criteria. They were divided into 2 groups. The study group (n = 56) and the control group (n = 57). The study group were given 50 μg of Misoprostol intravaginally every 4 hours to a maximum of 6 doses. Maternal age, gestational age, parity, initial cervical status, the rate of cesarean section, and neonatal outcomes were analyzed and compared to the control group.

RESULTS

The vaginal delivery was achieved in 69.6% in the study group versus 15.8% in the control group (p < 0.0001). The overall cesarean section was performed in 30.3% of the study group versus 84.2% (p < 0.0001). The mean time from insertion to delivery was 12.12 +/- 2.1 hours and the mean dosing was 2.77+/-1.3. There were no significant differences between the 2 groups in the frequency of abnormal fetal heart rate, Apgar score and admission to the neonatal intensive care unit.

CONCLUSION

Misoprostol when given intravaginally in 50 mcg 4-hourly dosing regimen is an effective agent for ripening the cervix in this group of women.