Hourly Low-Dose Oral Misoprostol Solution for Induction of Labour at Term: A Prospective Observational Study from a Pakistan
DOI:
https://doi.org/10.51985/JBUMDC2025794Keywords:
Cesarean Section, Labor, Induced, Misoprostol, Pakistan, Pregnancy, TermAbstract
Objectives: To evaluate the effectiveness and short-term safety of an hourly 20 µg oral misoprostol solution protocol for
induction of labour (IOL) in primigravid term pregnancies at a Pakistani tertiary center.
Study design and setting: Prospective observational study conducted in the Department of Gynecology & Obstetrics,
Sadiq Abbassi Hospital / Quaid-e-Azam Medical College, Bahawalpur, from 21-Nov-2024 to 21-May-2025.
Methodology: Primigravida with singleton, cephalic, 37–42-week gestations, Bishop score >5, and reactive CTG were
enrolled; women with prior uterine surgery or other contraindications to vaginal birth were excluded. Misoprostol 200 µg
was dissolved in 200 mL of water; 20 mL (20 µg) was given orally every hour until adequate uterine activity or a maximum
of 10 doses. Oxytocin was started if contractions became inadequate after active labour onset.
Results: One hundred women were included (mean age 27.20 ± 3.62 y; mean gestation 38.65 ± 1.51 weeks; mean estimated
fetal weight 2511.05 ± 265.42 g). Mean pre-induction Bishop score 6.32 ± 0.98 improved to 7.43 ± 1.65 at 6 h. The mean
induction-to-delivery interval was 12.43 ± 3.21 h; the mean misoprostol doses were 5.52 ± 1.62. Vaginal birth within 24
h occurred in 79/100 (79%; 95% CI 71–87). Oxytocin augmentation was required in 28% and meconium-stained liquor
occurred in 18%.
Conclusion: Hourly 20 µg oral misoprostol solution achieved high 24-h vaginal-delivery rates with generally reassuring
short-term outcomes within recorded parameters in primigravid women at term in this tertiary-care Pakistani cohort. Larger
comparative studies are warranted
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