Abstract

Abstract Background. Misoprostol, the prostaglandin E, analog, is increasingly used for cervical ripening and induction of labor. We evaluated our experience with misoprostol in an open‐ label setting. Methods. Patients were selected for cervical ripening based on clinical profile. At 3 cm cervical dilation, misoprostol was discontinued and other means of labor augmentation were used. Over 13 months, 470 inductions of labor occurred, and 455 charts were available; 254 patients (56%) received misoprostol for cervical ripening, and 144 (32%) received dinoprostone (prostaglandin E2). Results. With misoprostol, mean time from beginning of contractions until delivery was 7 hours, 30 minutes; vaginal birth occurred in 85% of cases, and spontaneous labor occurred in 38%. Hyperstimulation occurred in 4 cases (1.6%) and precipitate labor in 7 (3%). All infants were discharged in excellent condition; one had a 5‐minute Apgar score <7, and 33 (13%) had meconium, none with aspiration. Twenty‐three patients who had had a previous cesarean section received misoprostol and delivered vaginally. Conclusion. Misoprostol was found to be a safe and effective agent for cervical ripening as part of labor induction.