Effectiveness of two different doses of vaginal misoprostol for cervical ripening and labor induction - Revista Brasileira de Ginecologia e Obstetrícia

PURPOSE: to compare the effectiveness and safety of two different doses of misoprostol (12.5 mug and 25 mug) administered vaginally for cervical ripening and labor induction in term pregnancies with an indication for interruption. METHODS: this was a pilot randomized controlled single blinded trial, including 40 pregnant women treated with one of the two different doses of misoprostol. The independent variable was the dose of misoprostol and the main dependent variables were the mode of delivery, time between induction and delivery, perinatal complications and maternal side effects. The main control variables were maternal age, gestational age, literacy, parity, skin color and conditions of the cervix at the beginning of induction. For data analysis Student’s t test, chi2, exact Fisher, Wilcoxon and Kolmogorov-Smirnof tests were used, besides survival analysis. RESULTS: the groups using 12.5 and 25 mug were similar and did not present any significant difference regarding time for onset of uterine contractions (20.9±20.4 and 16.6±9.8 h, respectively), time between onset of uterine contractions and delivery (7.8±3.4 and 6.9±5.0 h), vaginal delivery (65 and 80%) and maternal and perinatal side effects (similar Apgar scores and hyperstimulation syndrome in both groups). CONCLUSION: the higher percentage of vaginal births and the shorter time for delivery using 25 mug, although not significant, does not allow to recommend the dose of 12.5 mug as more advantageous for cervical ripening and labor induction in term pregnancies.