Induction of Labor: The Misoprostol Controversy

摘要: Misoprostol (Cytotec) is safe and effective for induction of labor, although it not approved by the Food Drug Administration (FDA) use in pregnancy. In August 2000, manufacturer misoprostol warned against its pregnancy because abortifacient properties cited reports maternal fetal deaths when was used to induce fueling controversy. More than 45 randomized trials including more 5400 women have found vaginal be oxytocin or prostaglandin E2 at effecting delivery within 24 hours. Cesarean rates with are lower alone, but similar E2. There been no significant differences frequency serious adverse neonatal outcomes low-dose compared E2; however, relative risk rare unknown. The data suggest that absolute risks low appropriately. We recommend 25 mcg vaginally every 4 6 hours carefully selected patients closely monitored settings. Whether will prove most cost-effective agent inducing labor an unfavorable cervix remains determined.