Misoprostol: An Effective Agent for Cervical Ripening and Labor Induction: A 2-Year Review in a Tertiary Center

Abstract

Background: Misoprostol a PGE1 analogue has increasingly been used for cervical ripening in preparation for induction of labour with variable outcome for both mother and baby. Objectives: To determine the effectiveness of Misoprostol in cervical ripening and labour outcome in Aminu Kano Teaching Hospital Kano. Study Design: A study of all patients who had cervical ripening for induction of labour using Misoprostol at AKTH Kano, Nigeria, between 1st Jan 2012-31st Dec 2013. Socio-demographic data of these patients including number of doses inserted before ripening is achieved, duration, course and outcome of labour were documented. Result: Four hundred and two women were admitted for cervical ripening. 365 women met the inclusion criteria out of the 358 folders retrieved, giving a retrieval rate of 98%. Despite this six folders did not contain enough information for the study and were excluded leaving us with a sample size of 352. They had a successful cervical ripening with an average of 2 insertions. Spontaneous onset of labour without further intervention was observed in 266 women (75.5%). However, 86 women (24.5%) were induced with oxytocin following cervical ripening. The mean duration of labour among those that had spontaneous onset of labour following Misoprostol insertion was 9.8 hours. 96% of the patients had vaginal delivery while 4% had Caesarean section. Conclusion: Misoprostol was associated with favorable outcome following cervical ripening with a low caesarean section rate.

Share and Cite:

Ahmed, Z. , Garba, I. , Nafi’ah, T. and Yakasai, I. (2015) Misoprostol: An Effective Agent for Cervical Ripening and Labor Induction: A 2-Year Review in a Tertiary Center. Open Journal of Obstetrics and Gynecology, 5, 274-279. doi: 10.4236/ojog.2015.55040.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] American College of Obstetricians and Gynaecology (1999) Clinical Management Guidelines for Obstetricians-Gynaecologist. Induction of Labour. ACOG Practice Bulletin No. 19, The College, Washington DC.
[2] Ekele, B.A., Nnadi, D.C., Gana, M.A., Shehu, C.E., Ahmed, Y. and Nwobodo, E.I. (2007) Misoprostol Use for Cervical Ripening and Induction of Labour in a Nigerian Teaching Hospital. Nigerian Journal of Clinical Practice, 10, 234-273.
[3] Bako, B.G., Obed, J.Y. and Sanusi, I. (2008) Methods of Induction of Labour at University of Maiduguri Teaching Hospital, Maiduguri: A 4 Years Review. Nigerian Journal of Medicine, 17, 139-142.
http://dx.doi.org/10.4314/njm.v17i2.37272
[4] Austin, S.C., Sunchez-Ramos, L. and Adair, C.D. (2010) Labour Induction with Misoprostol Compared with Dinoprostone Vaginal Insert: A Systematic Review and Meta-Analysis. American Journal of Obstetrics Gynecology, 202, 624el-624e9.
[5] Abdul, M.A., Ibrahim, U.N., Yusuf, M.D. and Musa, A. (2007) Efficacy and Safety of Misoprostol in Induction of Labour in a Nigerian Tertiary Hospital. West African Journal of Medicine, 26, 213-216.
[6] Blanchard, K. and Clark, S.C. (2002) Misoprostol for Women’s Health: A Review. Obstetrics Gynecology, 99, 316-332.
http://dx.doi.org/10.1016/S0029-7844(01)01701-X
[7] Boulvain, M., Kelly, A. and Irion, O. (2008) Intracervical Prostaglandins for Induction of Labour. Cochrane Database Systemic Review, 1, Article ID: CD006971.
[8] Elati, A. and Week, A.D. (2009) The Misoprostol Use in Obstetrics and Gynaecology. BJOG, 116, 61.
[9] Onafowokan, O., Kailani, S., Offiong, R.A., Kwaghe, G.V., Akaba, G. and Otubu, J.A. (2006) Outcome of Labour Induced with Misoprostol. Tropical Journal of Obstetrics and Gynaecology, 23, S16.
[10] Lovold, A. and Stanton, C. (2008) A Report of a Working Meeting POPPHL Project. PATH, Washington DC.
[11] Loto, O.M., Ayuba, I.I., Adebara, I.O., Ikuomola, A.A. and Onwudiegwu, U.A. (2010) Randomized Clinical Trial of Misoprostol and Oxytocin for Induction of Labour. NJOG, 5, 44-48.
[12] Owolabi, A.T., Kuti, O. and Ogunlola, I.O. (2005) Randomised Trial of Intravaginal Misoprostol and Intracervical Foley Catheter for Cervical Ripening and Induction of Labour. Journal of Obstetrics and Gynaecology, 25, 565-568.
[13] Tabowei, T.O. and Oboro, V.O. (2003) Low-Dose Misoprostol versus Intracervical Ballon Catheter for Pre-Induction Cervical Ripening. East African Medical Journal, 80, 91-94.
[14] Ekele, B.A. and Oyetunji, J.A. (2002) Induction of Labour at Usmanu Danfodiyo University Teaching Hospital, Sokoto. Tropical Journal of Obstetrics and Gynaecology, 19, 74-77.
[15] Kwawukume, E.Y. and Ayertey, R.P. (2002) The Use of Misoprostol for Induction of Labour in a Low Resource Setting. Tropical Journal of Obstetrics and Gynaecology, 19, 78-81.
[16] Adeniji, O.A., Oladokun, A., Olayemi, O., Adeniji, O.I., Odukogbe, A.A., Ogunbode, O., Aimakhu, C.O., Omigbodun, A.O. and Ilesanmi, A.O. (2008) Pre-Induction Cervical Ripening: Transcervical Foley’s Catheter versus Intravaginal Misoprostol. Journal of Obstetrics and Gynaecology, 25, 134-139.
http://dx.doi.org/10.1080/01443610500040737

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.