Fletcher, Horace M.; Hutchinson, S.E.
Author Affiliation, Ana.
Department of Obstetrics, Gynaecology and Child Health
A retrospective review of pregnancy outcome after misoprostol (prostaglandin E1) induction of labour
West Indian Medical Journal
Date of Publication
This restrospective study looked at the outcome of using 50-100 ug mistroprostol once daily to induce labour compared to the outcome of the overall patient population delivered during the same period (1994-1996). During that period 11,255 patients were delivered and 1037 (9.2%) were induced with misoprostol. Results showed a significant lower mean Caesarean section rate: 9.3% for the misoprostol group versus 13.3% for the overall population (p=0.002,Odds Ratio (OR) 0.67, 95% CI 0.53, 0.83).The abruption rates were not significantly different: 0.8% for misoprostol versus 0.4% (p=0.009, OR 1.86, 95% CI 0.81,4.09).There was more postpartum haemorrhage in the misoprostol group: 5.6% versus 3.5% (p=0.0006, OR 1.63, 95% CI1.22, 2.19); a higher incidence of Apgar scores less than 6 at one minute 10.2% versus 2.4% (p=0.674, OR 1.09, CI0.73, 1.61) and a higher perinatal mortality rate 55/1000 versus 16.3/1000 (p=.000, OR 1.09, CI 2.55, 4.80). THe rate remained higher but not significantly so when a correction was made to eliminate the high number of intrauterine deaths induced with misoprostol 18/1000 versus 16.3/1000 (p=0.69, OR 1.11, 95% CI 0.66, 1.84). There were no cases of uterine rupture in either group. In conclusion, there was a significantly lower Caesarean section rate among patients who had once daily misprostol induction of labour. Close monitering of the foetus, in patients with misprostol; induction, is needed to detect foetal distress and prophylaxis against postpartum haemorrage is still mandatory.....