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Misoprostol use for cervical ripening and induction of labour in a Nigerian teaching hospital.

Nigerian journal of clinical practice

utilization, Abortifacient Agents, Nonsteroidal, adverse effects, pharmacology, therapeutic use, Adolescent, Adult, Cervical Ripening, Delivery, Obstetric, Female, Gestational Age, Hospitals, Teaching, Humans, Labor, Induced, methods, Misoprostol, Nigeria, Pregnancy, Prospective Studies, Risk Factors, Uterine Rupture

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      Abstract

      Induction of labor is always a challenge to many an obstetrician more so when the cervix is unfavorable. To determine the efficacy and safety ofmisoprostol in cervical ripening and labour induction. Aprospective study spanning 2 years and involving 151 patients admitted for cervical ripening and induction of labor at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. 50 microgram (mcg) ofmisoprostol was inserted vaginally every 4 hours until cervix became favorable or onset of labor. Main indications for induction of labour were prolonged pregnancy and hypertensive diseases of pregnancy. An average of 2 insertions of 50 mcg tablet was used to achieve cervical ripening in 107 patients (71%) and 80% (120) had spontaneous labor within 10 hours of insertion. The mean insertion-labor interval was 7.86 hours (SD +/- 2.5). The average duration of labour was 9.36 hours (SD +/- 2.9). Vaginal delivery was achieved in 96% of the patients. Uterine hyperstimulation occurred in 9 patients but there was no case of uterine rupture. Misoprostol was effective and safe in cervical ripening and induction of labor with a vaginal delivery rate of 96%. It should be an essential drug in obstetric practice especially in low resource settings.

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