Oral Misoprostol Solution In Comparison To Vaginal Misoprostol for Induction of Labour In a Randomized Controlled Trial Thesis

Abstract

Induction of labour at term is a common obstetric intervention. Induction of labour is the artificial initiation of labour before its spontaneous onset for the purpose of delivery of the feto-placental unit using mechanical or pharmacological methods. The goal of labour induction is to stimulate uterine contractions before spontaneous onset of labour, resulting in vaginal delivery. Examples of some common conditions where induction is often indicated include, but are not limited to:  Post-term pregnancy,  Prelabor (premature) rupture of membranes  Preeclampsia  Fetal demise  Maternal diabetes  Fetal growth restriction  Chorioamnionitis  Abruptio placentae  Cholestasis of pregnancy  Alloimmunization with fetal anemia CONTRAINDICATIONS  Prior uterine rupture  Prior classical or other high risk cesarean incision  Prior transmural uterine incision entering the uterine cavity  Active genital herpes infection  Placenta previa or vasa previa  Umbilical cord prolapse or persistent funic presentation  Transverse fetal lie  Invasive cervical cancer  Category III fetal heart rate tracing COMPLICATIONS  Tachysystole  Rupture uterus  Amniotic fluid embolism The ACOG recommends misoprostol as an efficient agent for cervical ripening and induction of labor at a dosage of 25 μg, administered intravaginally.However practitioners and researchers all over the globe have been interested to investigate its usage via other routes such as oral and other dosages which is considered off the label usage mostly between 25 and 50 μg dosages; on the other hand the active ingredient, instability is an issue that is still unresolved