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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Created on : 23 Dec 2003
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

A comparison of oral and vaginal misoprostol for induction of labour at term: a randomised trial. BJOG, International Journal of Obstetrics and Gynaecology. 2001 Jan;108(1):23-6.

Author(s) :

Kwon JS, Davies GA, Mackenzie VP.

Year of publication :


URL(s) :

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: To compare the efficacy of oral with vaginal misoprostol for induction of labour at term.

DESIGN: Randomised trial.

SETTING: Tertiary Care hospital.

PARTICIPANTS: One hundred and sixty-seven women requiring induction of labour.

METHODS: The women were randomised to receive 50 microg of misoprostol orally or vaginally every 6 h until the cervix was favourable for amniotomy, spontaneous rupture of membranes, or active labour occurred. Sample size was calculated with a two-tailed alpha of 0.05 and a power of 95% to detect a 5 h difference in induction-to-delivery time. Student’s t test was used for comparison of normally distributed continuous variables and the Mann-Whitney U test was used for non-Gaussian distributed continuous variables. Fisher’ s exact and chi2 tests were used for comparison of categorical variables. The main outcome measure was induction to delivery time.

RESULTS: The median induction to delivery time was significantly shorter with vaginal misoprostol (15.7 h range 4.3-55.7), compared with oral misoprostol (23.0 h range 3.2-141.7, P = 0.0013). The median number of doses was also significantly less in the vaginal misoprostol group, 1 (range 1-3), compared with the oral group, 2 (range 1-8), (P < 0.0001). The significant differences in outcome held true when nulliparous and multiparous women were analysed separately. There were no differences between the two routes of administration with respect to rates of hyperstimulation or neonatal asphyxia. There were more caesarean sections in the vaginal misoprostol group, but the difference was not statistically significant.

CONCLUSIONS: Compared with oral misoprostol, vaginal misoprostol for induction of labour at term results in a shorter induction-to-delivery time, with fewer doses required per patient. Vaginal misoprostol may be associated with higher rates of caesarean section than oral misoprostol.

Sumário (português)  :

Resumen (español)  :

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Argument (français) :

Comparaison de l’utilisation du misoprostol par voie orale et vaginale pour le déclenchement à terme

Argument (English):

Argumento (português):

Argumento (español):

Keywords :

➡ c-section/caesarean ; evidence-based medicine/midwifery ; physiology ; induction of labor ; fetal distress ; rupture of membranes ; amniotomy ; active management of labor ; post-term pregnancy ; misoprostol (Cytotec)

Author of this record :

Cécile Loup — 23 Dec 2003
➡ latest update : Bernard Bel — 02 Dec 2007

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