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The Experience of a Developing Country in Using Misoprostol for Induction of Labor

Objective: Assess the maternal and neonatal outcomes after use of vaginal misoprostol for induction of labor in resource limited situations Materials and Method: A prospective case control study, it included 200 pregnant women (100 of whom required Induction of labor for different indications and the other 100 pregnant women were in spontaneous labor. The route of misoprostol tablet administration was vaginal, starting with 25mcg every 6 hours with maximum 4 doses. Results: Median time from misoprostol administration to vaginal delivery was 16.0 hours, the most common indications of misoprostol were prelabor ruptured membrane 34%, post-date 27%, and oligohydramnios with fetal growth restriction 19%. The Apgar score of the neonates in 1 minute was < 7 in 45%, however it was down to 6% at 5 minutes of delivery in induced women. Admission to the neonatal care unit (NCU) in induced women was 40%, whereas 21% in women with spontaneous labor, the rate of admission to NCU in induced women was significantly higher in nulliparous women 73.8% compared to multiparous women 15.5% p<0.001, and also higher in women received more than 2 doses of misoprostol. Conclusion: Misoprostol is effective and safe for induction of labor when clinically indicated, however women should be counseled carefully regarding the maternal and fetal complications prior to induction with misoprostol.