Uzma Rahman Kallue, Nadra Sultana.
Vaginal Misoprostol - the revolutionary starter switch in induction of Labor.
Pak Armed Forces Med J Jan ;54(2):202-4.

To assess the role of vaginal misoprostol in cervical ripening in term pregnancies with minimum effective dose, and evaluating any side effects or complications in the mothers and fetuses in comparison with a placebo group. Experimental study. This study was conducted at Heavy Industries Taxila (HIT) hospital, Taxila, from July 2002 to May 2004. Cervical ripening was done in term pregnancies in 307 women with vaginally placed misoprostol. All subjects were monitored closely in labor using partograms. Fetal heart rate monitoring was done by intermittent auscultation using sonic aid / fetoscope. Control group consisted of 103 women. They were given no treatment. The subjects were randomly selected. Cervical ripening occurred in 99% of the 307 women in the experimental group. Induction-delivery time reduced significantly. Uterine hyperstimulation was not observed in any case. There was no marked difference in instrumental vaginal delivery in either group. Caesarean section rate was significantly reduced in the experimental group. 92.5 % delivered vaginally while 7.5 % underwent caesarean section. In the control group, 87.12% women delivered vaginally while 12.88% delivered by caesarean section. There were no significant side effects or complications in subjects or fetuses. The results prove that it is the safest and the most effective labour inducing agent to date. The dose in which it was used in the stud, is the optimum dose for its use vaginally. It achieved maximum results with minimal side effects in the mother and the fetus. Low cost, easy availability, stability at room temperature and excellent results give it an advantage over other induction agents.

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