Artigos Originais Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):75-79
DOI 10.1590/S0100-72032005000200006
PURPOSE: to evaluate perinatal outcomes in cases of oligohydramnios without premature rupture of membranes. METHODS: a total of 51 consecutive cases of oligohydramnios (amniotic fluid index, AFI < 5 cm) born between March 1998 and September 2001 were studied retrospectively. Data were compared to 61 cases with intermediate and normal volume of amniotic fluid AFI >5). Maternal and neonatal variables, as well as fetal mortality, early neonatal, and perinatal mortality rates were analyzed. For statistical analysis the c² test with Yates correction and Student's t test were used with level of signicance set at 5%. RESULTS: there were no significant differences between groups when the presence of gestational hypertensive syndromes, meconium-stained amniotic fluid, 1- and 5-minute Apgar score, need of neonatal intensive center unit, and preterm birth were analyzed. Oligohydramnios was associated with the way of delivery (p<0.0002; RR=0.3), fetal distress (p<0.0004; RR=2.2) and fetal malformations (p<0.01; RR=5.4). Fetal malformation rates were 17.6 and 3.3% in oligohydramnios and normal groups, respectively. Fetal mortality (2.0 vs 1.6%), early neonatal (5.9 vs 1.6%) and perinatal mortality (7.8 vs 3.3%) rates in both groups did not show statistical significance. CONCLUSION: Oligohydramnios was related to increased risk factor for cesarean section, fetal distress and fetal malformations.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):75-79
DOI 10.1590/S0100-72032005000200006
PURPOSE: to evaluate perinatal outcomes in cases of oligohydramnios without premature rupture of membranes. METHODS: a total of 51 consecutive cases of oligohydramnios (amniotic fluid index, AFI < 5 cm) born between March 1998 and September 2001 were studied retrospectively. Data were compared to 61 cases with intermediate and normal volume of amniotic fluid AFI >5). Maternal and neonatal variables, as well as fetal mortality, early neonatal, and perinatal mortality rates were analyzed. For statistical analysis the c² test with Yates correction and Student's t test were used with level of signicance set at 5%. RESULTS: there were no significant differences between groups when the presence of gestational hypertensive syndromes, meconium-stained amniotic fluid, 1- and 5-minute Apgar score, need of neonatal intensive center unit, and preterm birth were analyzed. Oligohydramnios was associated with the way of delivery (p<0.0002; RR=0.3), fetal distress (p<0.0004; RR=2.2) and fetal malformations (p<0.01; RR=5.4). Fetal malformation rates were 17.6 and 3.3% in oligohydramnios and normal groups, respectively. Fetal mortality (2.0 vs 1.6%), early neonatal (5.9 vs 1.6%) and perinatal mortality (7.8 vs 3.3%) rates in both groups did not show statistical significance. CONCLUSION: Oligohydramnios was related to increased risk factor for cesarean section, fetal distress and fetal malformations.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):69-74
DOI 10.1590/S0100-72032005000200005
PURPOSE: to determine the prevalence of overweight, obesity, and associated factors among women who visited a general gynecologic clinic in a secondary hospital of reference. METHODS: the following variables were studied: age, race, educational level, family income, job (paid work done by the women), type of the women's job, current partner, menstrual cycle characteristics at the time of interview, and body mass index (BMI). The patients were divided into three groups, according to their BMI values: <25 kg/m² (normal), between 25-29 kg/m² (overweight) and >30 kg/m² (obesity). The odds ratio (OR) and respective 95% confidence interval (95% CI) were calculated in the overweight and obese groups. Subsequently, the OR was calculated and adjusted for other variables. RESULTS: among the 676 studied women, 89.8% had received up to 8 years of formal education, 83.0% had a partner, 77.6% were Caucasian, 61.4% earned less than 5 minimum wages, and 36.0% of these women were menopausal. The prevalence of overweight was 35.6% and of obesity 24.6%. Overweight was related to age ranging from 50 to 59 years (OR: 3.22; 95% CI: 1.67-6.20) and menopause (OR: 1.52; 95% CI: 1.03-2.26), and obesity was related to menopause (OR: 2.57; 95% CI: 1.66-4.00) and to age range above 40 years (OR: 2.95; 95% CI: 1.37-6.37). According to the multiple regression analysis, only obesity was associated with age range above 40 years (OR: 2,51; 95% CI: 1.05-6.00). CONCLUSION: the prevalence rates of overweight and obesity were high in our sample of low-income women and those with less education. Obesity was associated with women aged over 40. Attempts should be made to reduce the prevalence of overweight and obesity in women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):69-74
DOI 10.1590/S0100-72032005000200005
PURPOSE: to determine the prevalence of overweight, obesity, and associated factors among women who visited a general gynecologic clinic in a secondary hospital of reference. METHODS: the following variables were studied: age, race, educational level, family income, job (paid work done by the women), type of the women's job, current partner, menstrual cycle characteristics at the time of interview, and body mass index (BMI). The patients were divided into three groups, according to their BMI values: <25 kg/m² (normal), between 25-29 kg/m² (overweight) and >30 kg/m² (obesity). The odds ratio (OR) and respective 95% confidence interval (95% CI) were calculated in the overweight and obese groups. Subsequently, the OR was calculated and adjusted for other variables. RESULTS: among the 676 studied women, 89.8% had received up to 8 years of formal education, 83.0% had a partner, 77.6% were Caucasian, 61.4% earned less than 5 minimum wages, and 36.0% of these women were menopausal. The prevalence of overweight was 35.6% and of obesity 24.6%. Overweight was related to age ranging from 50 to 59 years (OR: 3.22; 95% CI: 1.67-6.20) and menopause (OR: 1.52; 95% CI: 1.03-2.26), and obesity was related to menopause (OR: 2.57; 95% CI: 1.66-4.00) and to age range above 40 years (OR: 2.95; 95% CI: 1.37-6.37). According to the multiple regression analysis, only obesity was associated with age range above 40 years (OR: 2,51; 95% CI: 1.05-6.00). CONCLUSION: the prevalence rates of overweight and obesity were high in our sample of low-income women and those with less education. Obesity was associated with women aged over 40. Attempts should be made to reduce the prevalence of overweight and obesity in women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):64-68
DOI 10.1590/S0100-72032005000200004
PURPOSE: to determine the frequency of Mycoplasma hominis and Ureaplasma urealyticum infection, and relate it to the associated clinical variables of infertile women. METHODS: transversal study involving 322 infertile women, submitted to collection of endocervix swab for research of Mycoplasma hominis and Ureaplasma urealyticum infecction, from October 2002 to May 2004. All patients were submitted to a basic infertility investigation protocol. As control, a historical series of 51 non-pregnant women previously investigated as for the studied infectious agents, was used. RESULTS: the frequency of Mycoplasma hominis and Ureaplasma urealyticum infection was 4.9% in the infertile women and 13.8% in the control group. Among the infertile patients, a relationship between the presence of the two agents and changes in the histerosalpingography result (OR: 3.20; IC 95%: 1.05-9.73), presence of dyspareunia (OR: 10.72; IC 95%: 3.21-35.77) and vaginal discharge (OR: 8.5; IC 95%: 2.83-26.02), besides endocervical culture positive for Escherichia coli (OR: 6.09; IC 95%: 4.95-52.25) was observed. CONCLUSION: Mycoplasma hominis and Ureaplasma urealyticum infection rate is low in infertile patients and is associated with reproductive sequels.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):64-68
DOI 10.1590/S0100-72032005000200004
PURPOSE: to determine the frequency of Mycoplasma hominis and Ureaplasma urealyticum infection, and relate it to the associated clinical variables of infertile women. METHODS: transversal study involving 322 infertile women, submitted to collection of endocervix swab for research of Mycoplasma hominis and Ureaplasma urealyticum infecction, from October 2002 to May 2004. All patients were submitted to a basic infertility investigation protocol. As control, a historical series of 51 non-pregnant women previously investigated as for the studied infectious agents, was used. RESULTS: the frequency of Mycoplasma hominis and Ureaplasma urealyticum infection was 4.9% in the infertile women and 13.8% in the control group. Among the infertile patients, a relationship between the presence of the two agents and changes in the histerosalpingography result (OR: 3.20; IC 95%: 1.05-9.73), presence of dyspareunia (OR: 10.72; IC 95%: 3.21-35.77) and vaginal discharge (OR: 8.5; IC 95%: 2.83-26.02), besides endocervical culture positive for Escherichia coli (OR: 6.09; IC 95%: 4.95-52.25) was observed. CONCLUSION: Mycoplasma hominis and Ureaplasma urealyticum infection rate is low in infertile patients and is associated with reproductive sequels.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):58-63
DOI 10.1590/S0100-72032005000200003
PURPOSE: to evaluate the distribution of yeast species isolated from the vagina in two cities of the South of Brazil and compare the in vitro susceptibility profile of these yeasts against some antifungals, which are used in clinical routine. METHODS: all women attended from January to June 2004 for vaginal routine examinations, independent of being symptomatic or not were included in the study. Only those who presented immunodeficiency like AIDS or any other genital infection were excluded. Samples of vaginal discharge from the women (Jaraguá do Sul - SC (n=130) and Maringá - PR (n=97)) were cultivated. The yeasts were identified and submitted to the susceptibility test against the antifungals fluconazole, nystatin and amphotericin B. RESULTS: the frequency of positive cultures for yeasts was the same in both cities; C. albicans was the most prevalent species (about 24%), but its frequency was different: in SC it corresponded to 77.4% of the yeasts both in symptomatic and asymptomatic women and in PR it was 50.0% with predominance in symptomatic women. We observed high rates of susceptibility to fluconazole and amphotericin B, but 51.1% of the yeasts presented dose-dependent susceptibility (DDS) to nystatin. C. albicans showed a higher tendency to be nystatin resistant (52.8% DDS) than non-albicans species (44.4%). CONCLUSIONS: our data showed geographic differences among the species of yeasts isolated from the vagina and suggest that this fact has clinical relevance considering the differences in susceptibility, especially regarding nystatin, which could be important for the management of vulvovaginal candidiasis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):58-63
DOI 10.1590/S0100-72032005000200003
PURPOSE: to evaluate the distribution of yeast species isolated from the vagina in two cities of the South of Brazil and compare the in vitro susceptibility profile of these yeasts against some antifungals, which are used in clinical routine. METHODS: all women attended from January to June 2004 for vaginal routine examinations, independent of being symptomatic or not were included in the study. Only those who presented immunodeficiency like AIDS or any other genital infection were excluded. Samples of vaginal discharge from the women (Jaraguá do Sul - SC (n=130) and Maringá - PR (n=97)) were cultivated. The yeasts were identified and submitted to the susceptibility test against the antifungals fluconazole, nystatin and amphotericin B. RESULTS: the frequency of positive cultures for yeasts was the same in both cities; C. albicans was the most prevalent species (about 24%), but its frequency was different: in SC it corresponded to 77.4% of the yeasts both in symptomatic and asymptomatic women and in PR it was 50.0% with predominance in symptomatic women. We observed high rates of susceptibility to fluconazole and amphotericin B, but 51.1% of the yeasts presented dose-dependent susceptibility (DDS) to nystatin. C. albicans showed a higher tendency to be nystatin resistant (52.8% DDS) than non-albicans species (44.4%). CONCLUSIONS: our data showed geographic differences among the species of yeasts isolated from the vagina and suggest that this fact has clinical relevance considering the differences in susceptibility, especially regarding nystatin, which could be important for the management of vulvovaginal candidiasis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):51-57
DOI 10.1590/S0100-72032005000200002
PURPOSE: to estimate the validity of visual inspection of cervical intraepithelial neoplasia (CIN) and HPV-induced lesion screening, after acetic acid application (VIA), and to compare its performance with that of colpocytology and colposcopy. METHODS: a diagnostic test validation study involving 893 women aged 18 to 65 years, simultaneously screened with colpocytology, VIA and colposcopy was carried out at a public health unit in Recife, PE. VIA was performed by applying 5% acetic acid onto the cervix and observing it with the help of a clinical spotlight. The finding of any aceto-white lesion on the cervix was considered positive. The gold standard was the histopathology of cervical biopsy, carried out whenever any of the three test results was abnormal. Validity indicators were estimated for each test, within 95% confidence intervals. The analysis of agreement between test results was done by the kappa coefficient. RESULTS: of 303 women submitted to biopsy, the histopathological study was abnormal in 24. Among this total, VIA was positive in 22, yielding an estimated 91.7% sensibility, 68.9% specificity, and 7.5% positive predictive value and 99.7% negative predictive value. Comparing 95% confidence intervals, VIA was more sensitive than colpocytology, despite a lower specificity and positive predictive value. There was poor agreement between VIA and colpocytology (k=0.02) and excellent agreement with colposcopy (k=0.93). CONCLUSION: VIA was much more sensitive than colpocytology in the screening of CIN and HPV-induced lesions and presented a performance similar to colposcopy. Its low specificity determined a high number of false-positive results.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):51-57
DOI 10.1590/S0100-72032005000200002
PURPOSE: to estimate the validity of visual inspection of cervical intraepithelial neoplasia (CIN) and HPV-induced lesion screening, after acetic acid application (VIA), and to compare its performance with that of colpocytology and colposcopy. METHODS: a diagnostic test validation study involving 893 women aged 18 to 65 years, simultaneously screened with colpocytology, VIA and colposcopy was carried out at a public health unit in Recife, PE. VIA was performed by applying 5% acetic acid onto the cervix and observing it with the help of a clinical spotlight. The finding of any aceto-white lesion on the cervix was considered positive. The gold standard was the histopathology of cervical biopsy, carried out whenever any of the three test results was abnormal. Validity indicators were estimated for each test, within 95% confidence intervals. The analysis of agreement between test results was done by the kappa coefficient. RESULTS: of 303 women submitted to biopsy, the histopathological study was abnormal in 24. Among this total, VIA was positive in 22, yielding an estimated 91.7% sensibility, 68.9% specificity, and 7.5% positive predictive value and 99.7% negative predictive value. Comparing 95% confidence intervals, VIA was more sensitive than colpocytology, despite a lower specificity and positive predictive value. There was poor agreement between VIA and colpocytology (k=0.02) and excellent agreement with colposcopy (k=0.93). CONCLUSION: VIA was much more sensitive than colpocytology in the screening of CIN and HPV-induced lesions and presented a performance similar to colposcopy. Its low specificity determined a high number of false-positive results.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):7-11
DOI 10.1590/S0100-72032005000100003
PURPOSE: to compare pregnancy rates and mean endometrial thickness obtained with three protocols for induction of ovulation in cycles of intrauterine insemination (IUI). METHODS: one hundred and ten IUI cycles were retrospectively evaluated in the study, divided into three groups, according to the used ovulation induction protocols: 100 mg clomiphene citrate (CC) on days 3 to 7 of the cycle (CC group, n=24), 100 mg/day CC on days 3 to 7 of the cycle + 75 IU/day of human menopausal gonadotrophin (hMG) on days 3, 5 and 7 of the cycle (CC+hMG group, n=29), and 75 IU/day of hMG on days 3 to 8 of the cycle (hMG group, n=57). Statistical analysis was performed using Student's t test to compare the means and the c² test to compare the rates. Results were considered statistically significant at p<0.05. RESULTS: the patients' average age at the onset of the first cycle was 2340 years (mean age, 33.3 years). There were no statistically significant differences between groups. The mean endometrial thickness on the day of the human chorionic gonadotrophin (hCG) administration was significantly higher in the hMG group (10.2±0.2 mm), as compared with the CC and CC+hMG group (7.9±0.4 and 8.7±0.2 mm, respectively, p<0.001). The overall clinical pregnancy rate was 18.2%, and there were no statistically significant differences between the groups (CC group=12.5%; CC+hMG group=24.1% and hMG group=19.3%). CONCLUSION: the results indicate higher mean endometrial thickness in the hMG group as compared with the CC group and the CC+hMG group. There were no significant differences between clinical pregnancy rates obtained with each protocol (CC, CC+hMG and hMG).
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):7-11
DOI 10.1590/S0100-72032005000100003
PURPOSE: to compare pregnancy rates and mean endometrial thickness obtained with three protocols for induction of ovulation in cycles of intrauterine insemination (IUI). METHODS: one hundred and ten IUI cycles were retrospectively evaluated in the study, divided into three groups, according to the used ovulation induction protocols: 100 mg clomiphene citrate (CC) on days 3 to 7 of the cycle (CC group, n=24), 100 mg/day CC on days 3 to 7 of the cycle + 75 IU/day of human menopausal gonadotrophin (hMG) on days 3, 5 and 7 of the cycle (CC+hMG group, n=29), and 75 IU/day of hMG on days 3 to 8 of the cycle (hMG group, n=57). Statistical analysis was performed using Student's t test to compare the means and the c² test to compare the rates. Results were considered statistically significant at p<0.05. RESULTS: the patients' average age at the onset of the first cycle was 2340 years (mean age, 33.3 years). There were no statistically significant differences between groups. The mean endometrial thickness on the day of the human chorionic gonadotrophin (hCG) administration was significantly higher in the hMG group (10.2±0.2 mm), as compared with the CC and CC+hMG group (7.9±0.4 and 8.7±0.2 mm, respectively, p<0.001). The overall clinical pregnancy rate was 18.2%, and there were no statistically significant differences between the groups (CC group=12.5%; CC+hMG group=24.1% and hMG group=19.3%). CONCLUSION: the results indicate higher mean endometrial thickness in the hMG group as compared with the CC group and the CC+hMG group. There were no significant differences between clinical pregnancy rates obtained with each protocol (CC, CC+hMG and hMG).
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):37-43
DOI 10.1590/S0100-72032005000100008
PURPOSE: to investigate the normal peak expiratory flow values in healthy pregnant women employing a portable expiratory apparatus (Mini-Wright Peak Flow Meter), and to relate the obtained measurements to each patient's height, body mass index (BMI) and age, along gestation. METHODS: a longitudinal prospective study including 26 pregnant women followed up from the first trimester to the 36th week of gestation and examined every four weeks. On the occasion of seven visits, the pregnant women performed forced exhaling into a portable expiratory apparatus three times, with the highest value being considered the peak expiratory flow. All measurements were made under the same investigator's supervision in order to reduce the margin of error. Pearson coefficient was used to calculate the correlation between flow and BMI, between flow and patient's height, and between flow and patient's age. RESULTS: the variation in flow values during pregnancy can be determined by flow = 328.32 -0.07 x week, with a Pearson coefficient equal to zero. To determine whether there was a difference in the correlation coefficients between BMI and flow, we compared the lowest coefficient (0.47 for week 30, flow = 123.49 + 7.64 x BMI) with the highest coefficient (0.59 for week 34, flow = 87.77 + 9.05 x BMI) of each studied time interval and obtained a value of 0.22, indicating a good correlation between the flow and BMI variables. There was a positive correlation between height and flow (Pearson = 0.61), with flow = -477.47 + 497.38 x height. The correlation coefficient between flow and age was 0.24, with the equation obtained in this case being non-linear. CONCLUSIONS: peak expiratory flow values did not change along gestation. Higher flows were observed in taller women. Pregnant women with a higher BMI before gestation presented higher flows. There was no correlation between flow and maternal age.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):37-43
DOI 10.1590/S0100-72032005000100008
PURPOSE: to investigate the normal peak expiratory flow values in healthy pregnant women employing a portable expiratory apparatus (Mini-Wright Peak Flow Meter), and to relate the obtained measurements to each patient's height, body mass index (BMI) and age, along gestation. METHODS: a longitudinal prospective study including 26 pregnant women followed up from the first trimester to the 36th week of gestation and examined every four weeks. On the occasion of seven visits, the pregnant women performed forced exhaling into a portable expiratory apparatus three times, with the highest value being considered the peak expiratory flow. All measurements were made under the same investigator's supervision in order to reduce the margin of error. Pearson coefficient was used to calculate the correlation between flow and BMI, between flow and patient's height, and between flow and patient's age. RESULTS: the variation in flow values during pregnancy can be determined by flow = 328.32 -0.07 x week, with a Pearson coefficient equal to zero. To determine whether there was a difference in the correlation coefficients between BMI and flow, we compared the lowest coefficient (0.47 for week 30, flow = 123.49 + 7.64 x BMI) with the highest coefficient (0.59 for week 34, flow = 87.77 + 9.05 x BMI) of each studied time interval and obtained a value of 0.22, indicating a good correlation between the flow and BMI variables. There was a positive correlation between height and flow (Pearson = 0.61), with flow = -477.47 + 497.38 x height. The correlation coefficient between flow and age was 0.24, with the equation obtained in this case being non-linear. CONCLUSIONS: peak expiratory flow values did not change along gestation. Higher flows were observed in taller women. Pregnant women with a higher BMI before gestation presented higher flows. There was no correlation between flow and maternal age.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):24-31
DOI 10.1590/S0100-72032005000100006
PURPOSE: to compare the effectiveness and safety of sublingual misoprostol (25 µg) versus vaginal misoprostol (25 µg) (Prostokos®) for labor induction with gestational age > 37 weeks and unripe cervices. METHODS: a randomized controlled clinical trial was performed at the Maternidade Monteiro de Morais (CISAM-UPE), in Recife - PE, Brazil, from October 2003 to February 2004. One hundred and twenty-three women with gestational age > 37 weeks, Bishop score <8, not in labor and with medical indication for interruption of pregnancy were included in this study. The women received randomly 25 µg sublingual misoprostol or 25 µg vaginal misoprostol every 6 h, not exceeding eight doses. In order to evaluate the differences between the groups, means, standard deviations, Student's t-test, c² trend and Mann-Whitney test were used. The statistical significance was considered to be 5%. RESULTS: there were no significant differences between the number of women with vaginal delivery in the sublingual group as compared with the vaginal group (65.5 vs 75.8%, p<0.22), or in the interval of time between the induction onset and delivery (24 h and 42 min vs 20 h and 37 min respectively, p=0.11). The two groups, sublingual and vaginal, also did not differ as to the hyperstimulation syndrome (1.7 vs 3.2%, p=0.95), meconium incidence (5.2 vs 4.8%, p=0.74), Apgar score <7 at 5 min (3.4 vs 4.8%, p=0.98) and other adverse effects. CONCLUSION: twenty-five micrograms of sublingual misoprostol every six h presented the same effectiveness and safety as an equal vaginally administered dose of this substance. Sublingual misoprostol seems to be acceptable and is another option to be considered for labor induction.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):24-31
DOI 10.1590/S0100-72032005000100006
PURPOSE: to compare the effectiveness and safety of sublingual misoprostol (25 µg) versus vaginal misoprostol (25 µg) (Prostokos®) for labor induction with gestational age > 37 weeks and unripe cervices. METHODS: a randomized controlled clinical trial was performed at the Maternidade Monteiro de Morais (CISAM-UPE), in Recife - PE, Brazil, from October 2003 to February 2004. One hundred and twenty-three women with gestational age > 37 weeks, Bishop score <8, not in labor and with medical indication for interruption of pregnancy were included in this study. The women received randomly 25 µg sublingual misoprostol or 25 µg vaginal misoprostol every 6 h, not exceeding eight doses. In order to evaluate the differences between the groups, means, standard deviations, Student's t-test, c² trend and Mann-Whitney test were used. The statistical significance was considered to be 5%. RESULTS: there were no significant differences between the number of women with vaginal delivery in the sublingual group as compared with the vaginal group (65.5 vs 75.8%, p<0.22), or in the interval of time between the induction onset and delivery (24 h and 42 min vs 20 h and 37 min respectively, p=0.11). The two groups, sublingual and vaginal, also did not differ as to the hyperstimulation syndrome (1.7 vs 3.2%, p=0.95), meconium incidence (5.2 vs 4.8%, p=0.74), Apgar score <7 at 5 min (3.4 vs 4.8%, p=0.98) and other adverse effects. CONCLUSION: twenty-five micrograms of sublingual misoprostol every six h presented the same effectiveness and safety as an equal vaginally administered dose of this substance. Sublingual misoprostol seems to be acceptable and is another option to be considered for labor induction.
