Misoprostol for induction of labor in women with severe preeclampsia at or near term.

OBJECTIVES: To examine the misoprostol efficacy and safety in induction of labor of women with severe preeclampsia at or near term when the cervix is unfavorable.

METHODS: A prospective comparative study was conducted in Al-Thawara General Hospital Sana'a , Yemen, from June 2009 to June 2010. One hundred and thirteen women met the inclusion criteria. They were divided into 2 groups. The study group (n = 56) and the control group (n = 57). The study group were given 50 µg of Misoprostol intravaginally every 4 hours to a maximum of 6 doses. Maternal age, gestational age, parity, initial cervical status, the rate of cesarean section, and neonatal outcomes were analyzed and compared to the control group.

RESULTS: The vaginal delivery was achieved in 69.6% in the study group versus 15.8% in the control group (p < 0.0001). The overall cesarean section was performed in 30.3% of the study group versus 84.2% (p < 0.0001). The mean time from insertion to delivery was 12.12 ± 2.1 hours and the mean dosing was 2.77±1.3. There were no significant differences between the 2 groups in the frequency of abnormal fetal heart rate, Apgar score and admission to the neonatal intensive care unit.

CONCLUSIONS: Misoprostol when given intravaginally in 50 mcg 4-hourly dosing regimen is an effective agent for ripening the cervix in this group of women.