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Daniel R. Mishell - One of the best experts on this subject based on the ideXlab platform.
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a prospective randomized double blinded placebo controlled trial comparing mifepristone and vaginal Misoprostol to vaginal Misoprostol alone for elective termination of early pregnancy
Human Reproduction, 2002Co-Authors: John K Jain, Caryn Dutton, Bryna Harwood, Karen R Meckstroth, Daniel R. MishellAbstract:BACKGROUND Vaginal Misoprostol has been shown to be an effective single agent for medical abortion. This randomized, double-blinded, placebo-controlled trial compared a regimen of mifepristone and Misoprostol with Misoprostol alone for termination of early pregnancy. METHODS 250 women with gestations < or = 56 days were randomized by a random number table to receive either 200 mg mifepristone orally or placebo followed 48 h later by 800 microg vaginal Misoprostol. Administration of Misoprostol was repeated every 24 h up to three doses if abortion failed to occur. Abortion success was defined as complete abortion without the use of surgical aspiration. RESULTS Successful medical abortions occurred in 114 out of 119 subjects (95.7%) after mifepristone followed by vaginal Misoprostol. In all, 110 out of 125 subjects (88.0%) successfully aborted after placebo and vaginal Misoprostol. The higher success rate of complete abortion with the mifepristone and Misoprostol regimen was statistically significant compared with the placebo and Misoprostol regimen (P < 0.05). CONCLUSIONS A regimen of mifepristone and Misoprostol was significantly more effective for termination of pregnancies < or = 56 days than Misoprostol alone. The 88% efficacy obtained with vaginal Misoprostol alone may be clinically acceptable when mifepristone is not available.
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a comparison of Misoprostol with and without laminaria tents for induction of second trimester abortion
American Journal of Obstetrics and Gynecology, 1996Co-Authors: John K Jain, Daniel R. MishellAbstract:Abstract OBJECTIVE: Our purpose was to determine whether intracervical placement of laminaria tents would improve the effectiveness of the prostaglandin analog Misoprostol for the elective termination of pregnancies in the second trimester. STUDY DESIGN: Sixty-eight women between 12 and 22 weeks of gestation with either an intrauterine fetal death ( n = 40) or medical or genetic indications for pregnancy termination ( n = 30) were randomized to receive 200 μ g of Misoprostol administered vaginally every 12 hours with or without intracervical placement of laminaria concurrently with the first dose of Misoprostol. RESULTS: The rate of abortion 24 hours after initiation of treatment was 69.7% in the 33 women receiving Misoprostol alone and 68.6% in the 35 women treated with Misoprostol and laminaria. The abortion rates 48 hours after initiation of treatment were 84.8% and 91.4%, respectively, an insignificant difference. The complete abortion rate was also similar between women receiving Misoprostol alone (39.3%) and the group receiving Misoprostol and laminaria (37.5%). There were no significant differences in the incidence of fever, vomiting, diarrhea, or pain. The mean interval from initiation of treatment to abortion was also similar, 15.7 hours in those receiving Misoprostol alone and 17.4 hours in those treated with Misoprostol and laminaria. In both groups women who had live fetuses at the start of the procedure had a higher failure rate of abortion and a longer time interval to abortion than women whose fetus was dead. CONCLUSIONS: Laminaria tents inserted concurrently with the first dose of Misoprostol do not significantly improve the abortifacient effect of vaginal Misoprostol in the second trimester of pregnancy. (Am J Obstet Gynecol 1996;175:173-7.)
Beverly Winikoff - One of the best experts on this subject based on the ideXlab platform.
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Comparison of Misoprostol-only and combined mifepristone–Misoprostol regimens for home-based early medical abortion in Tunisia and Vietnam
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2012Co-Authors: Jennifer Blum, Sheila Raghavan, Rasha Dabash, Nguyen Thi Nhu Ngoc, H. Chelli, Selma Hajri, Kathryn Conkling, Beverly WinikoffAbstract:Abstract Objective To assess the potential advantages of combined mifepristone–Misoprostol versus Misoprostol-only for early medical abortion. Methods A double-blind randomized placebo controlled study was conducted that enrolled 441 pregnant women ( Results Successful uterine evacuation occurred for 78.0% (n = 170) of women with Misoprostol only versus 92.9% (n = 195) of women with mifepristone–Misoprostol (relative risk 0.84, 95% CI, 0.78–0.91; P P Conclusion Mifepristone plus Misoprostol is significantly more effective than Misoprostol-only for early medical abortion. Clinical trials.gov registration number: NCT00680394 .
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a randomized controlled trial of 400 μg sublingual Misoprostol versus manual vacuum aspiration for the treatment of incomplete abortion in two egyptian hospitals
International Journal of Gynecology & Obstetrics, 2010Co-Authors: Rasha Dabash, Jennifer Blum, Mohamed Cherine Ramadan, E Darwish, Nevine Hassanein, Beverly WinikoffAbstract:Abstract Objective To compare the safety, efficacy, and acceptability of 400-μg sublingual Misoprostol with that of manual vacuum aspiration (MVA) in 2 Egyptian hospitals. Methods Participating women were randomized to either MVA or Misoprostol treatment for incomplete abortion. The primary outcome, complete uterine evacuation, was determined 1 week later, as were adverse effects, change in hemoglobin, acceptability, and satisfaction. Results Complete uterine evacuation was achieved in 98.3% of women who received Misoprostol and 99.7% who underwent MVA (relative risk [RR] 0.99; 95% confidence interval [CI], 0.97–1.00). A decrease in hemoglobin of 2 g/dL or more was comparably rare in the 2 groups (0.3% Misoprostol vs 0.9% MVA; RR 0.34 [95% CI, 0.04–3.21]). Mean change in hemoglobin was also clinically similar (–0.5 g/dL Misoprostol vs –0.4 g/dL MVA; P Conclusion The high efficacy, safety, and acceptability of 400-μg sublingual Misoprostol indicate that it is analogous to surgery as a first-line treatment for incomplete abortion. Misoprostol might improve post-abortion care when resources are limited and surgical treatment is unavailable.
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Comparing two early medical abortion regimens: mifepristone+Misoprostol vs. Misoprostol alone.
Contraception, 2010Co-Authors: Nguyen Thi Nhu Ngoc, Jennifer Blum, Sheila Raghavan, Rasha Dabash, Nguyen Thi Bach Nga, Ayisha Diop, Beverly WinikoffAbstract:Abstract Background Nonsurgical abortion methods have the potential to improve access to high-quality abortion care. Until recently, availability and utilization of mifepristone medical abortion in low-resource countries were restricted due to the limited availability and perceived high cost of mifepristone, leading some providers and policymakers to support use of Misoprostol-only regimens. Yet, this may not be desirable if Misoprostol-only regimens are considerably less effective and ultimately more costly for health care systems. This study sought to document the differences in efficacy between two nonsurgical abortion regimens. Study Design This double-blind randomized placebo-controlled trial enrolled women with gestational ages up to 63 days seeking early medical abortion from August 2007 to March 2008 at a large tertiary hospital in Ho Chi Minh City, Vietnam. Eligible consenting women received either (1) two doses of 800 mcg buccal Misoprostol 24 h apart or (2) 200 mg mifepristone and 800 mcg buccal Misoprostol 24 h later. Participants self-administered all study drugs and returned to the hospital for follow-up 1 week later. The trial is registered at ClinicalTrials.gov as NCT00680394. Results Four hundred women were randomized to either Misoprostol-only (198) or mifepristone+Misoprostol (202). Complete abortion occurred for 76.2% ( n =147) of women allocated to Misoprostol-only vs. 96.5% ( n =194) of those given mifepristone+Misoprostol (RR 0.79, 95% CI 0.73–0.86). Ongoing pregnancy was documented for 16.6% (32) of Misoprostol-only users and 1.5% (3) of mifepristone+Misoprostol users (1.62, 0.68–3.90). Side effects were generally similar for both groups, although significantly more women allocated to Misoprostol-only reported diarrhea. Conclusions Mifepristone+Misoprostol is significantly more effective than use of Misoprostol-alone for early medical abortion. The number of ongoing pregnancies documented with Misoprostol-only warranted an early end of the trial after unblinding of the study at interim analysis. Policymakers should advocate for greater access to mifepristone. Future research should prioritize Misoprostol-only regimens with shorter dosing intervals.
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is Misoprostol a safe effective and acceptable alternative to manual vacuum aspiration for postabortion care results from a randomised trial in burkina faso west africa
British Journal of Obstetrics and Gynaecology, 2007Co-Authors: B Dao, Jennifer Blum, Sheila Raghavan, B Thieba, M Ouedraego, J Lankoande, Beverly WinikoffAbstract:Objectives Previous research has demonstrated the effectiveness of Misoprostol for treatment of incomplete abortion; however, few studies have systematically compared Misoprostol’s effectiveness with that of standard surgical care. This study documents the effectiveness of a single 600 micrograms dose of oral Misoprostol versus manual vacuum aspiration (MVA) for treatment of incomplete abortion in a developing country setting. Design Open-label randomised controlled trial. Setting Two university teaching hospitals in Burkina Faso, West Africa. Population Women of reproductive age presenting with incomplete abortion. Methods From April 2004 through October 2004, 447 consenting women with incomplete abortion were randomised to either a single dose of 600 micrograms oral Misoprostol or MVA for treatment of their condition. Main outcome measure Completed abortion following initial treatment. Results Regardless of treatment assigned, nearly all participants had a complete uterine evacuation (Misoprostol = 94.5%, MVA = 99.1%; relative risk [RR] = 0.95 [95% CI 0.92–0.99]). Acceptability and satisfaction ratings were similar and high for both Misoprostol and MVA, with three out of four women indicating that the treatment’s adverse effects were tolerable (Misoprostol = 72.9%, MVA = 75.8%; RR = 0.96 [95% CI 0.86–1.07]). The majority of women were ‘satisfied’ or ‘very satisfied’ with the method they received (Misoprostol = 96.8%, MVA = 97.7%; RR = 0.99 [95% CI 0.96–1.02]), expressed a desire to choose that method again (Misoprostol = 94.5%, MVA = 86.6%; RR = 1.09 [95% CI 1.03–1.16]) and to recommend it to a friend (Misoprostol = 94.5%, MVA = 85.2%; RR = 1.11 [95% CI 1.04–1.18]). Conclusion Six hundred micrograms of oral Misoprostol is as safe and acceptable as MVA for the treatment of incomplete abortion. Operations research is needed to ascertain the role of Misoprostol within postabortion care programmes worldwide.
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Misoprostol for treatment of incomplete abortion at the regional hospital level results from tanzania
British Journal of Obstetrics and Gynaecology, 2007Co-Authors: B Shwekerela, R Kalumuna, R Kipingili, N Mashaka, E Westheimer, W Clark, Beverly WinikoffAbstract:Objective To investigate the safety, efficacy, and acceptability of Misoprostol versus manual vacuum aspiration (MVA) for treatment of incomplete abortion. Design A prospective open-label randomised trial. Setting Kagera Regional Hospital, Bukoba, Tanzania. Sample Three hundred women with a clinical diagnosis of incomplete abortion and a uterine size <12 weeks. Methods A total of 150 women were randomised to either a single dose of 600 micrograms of oral Misoprostol or MVA. If abortion was clinically complete at 7-day follow up, the woman was released from the study. If it was still incomplete, the woman was offered the choice of an additional 1-week follow up or immediate MVA. Cases still incomplete after a further week were offered MVA. Main outcome measures Incidence of successful abortion (success defined as no secondary surgical intervention provided), incidence of adverse effects, patient satisfaction. Results Success was very high in both arms (Misoprostol: 99%; MVA: 100%; difference not significant). Most adverse effects were higher in the Misoprostol arm, although the mean pain score was higher in the MVA arm (3.0 versus 3.5; P < 0.001). More women were very satisfied with Misoprostol (75%) than with MVA (55%, P= 0.001), and a higher proportion of women in the Misoprostol arm said that they would recommend the treatment to a friend (95% versus 75%, P < 0.001). Conclusion Misoprostol is as effective as MVA at treating incomplete abortion at uterine size of <12 weeks. The acceptability of Misoprostol appears higher. Given the many practical advantages of Misoprostol over MVA in low-resource settings, Misoprostol should be more widely available for treatment of incomplete abortion in the developing world.
Daniel Grossman - One of the best experts on this subject based on the ideXlab platform.
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Mifepristone-Misoprostol versus Misoprostol-alone regimen for medication abortion at ≥24 weeks' gestation.
Contraception, 2020Co-Authors: Erin Wingo, Sarah Raifman, Carmen Landau, Shelley Sella, Daniel GrossmanAbstract:Abstract Objective To compare time from Misoprostol initiation to fetal expulsion for mifepristone–Misoprostol versus Misoprostol-alone regimens of medication abortion performed at ≥24 weeks’ gestation. Study design We conducted a retrospective study of medication abortion performed at ≥24 weeks’ gestation between May 2016 and January 2018 at one site, comparing outcomes of patients receiving mifepristone–Misoprostol versus Misoprostol alone during two periods. All patients received feticidal injection and laminaria; the mifepristone–Misoprostol group also received mifepristone 200 mg orally around the time of initial laminaria. Beginning 24–72 h later (depending on cervical assessment), both groups received Misoprostol buccally every two hours. Results Analyses included 257 patients in the mifepristone–Misoprostol group and 152 patients in the Misoprostol-alone group. Median time from Misoprostol initiation to fetal expulsion was similar between groups (4.8 h vs. 4.9 h; p = 0.43). Patients in the mifepristone–Misoprostol group received less Misoprostol overall (median [IQR]: 800 mcg [800–1200 mcg] vs. 1200 mcg [800–1600 mcg]; p Conclusions Addition of mifepristone was not associated with a reduction in induction interval at ≥24 weeks. However, patients in the mifepristone–Misoprostol group received a lower total dose of Misoprostol and were less likely to require two days of laminaria. The clinical significance of these differences is unclear, but may have implications for patient experience. Both regimens had low rates of complications. Implications A randomized controlled trial comparing the mifepristone–Misoprostol and Misoprostol-alone regimens at ≥24 weeks is needed, as is evidence on patient perspectives on these regimens. Given the existing evidence, either regimen is reasonable.
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a randomized controlled trial of laminaria oral Misoprostol and vaginal Misoprostol before abortion
Obstetrics & Gynecology, 1999Co-Authors: Laura Macisaac, Elizabeth Balistreri, Daniel Grossman, Philip D. DarneyAbstract:Abstract Objective: To compare the efficacy and acceptability of oral Misoprostol, vaginal Misoprostol, and laminaria tents for cervical dilation before surgical abortion. Methods: We conducted a randomized, double-blind, placebo-controlled trial comparing oral Misoprostol 400 μg, vaginal Misoprostol 400 μg, and one medium laminaria for dilating the cervix over 4 hours before surgical abortion. The study sample consisted of 106 women at 7–14 weeks’ gestation who presented to San Francisco General Hospital requesting abortion. The primary outcome was the amount of cervical dilation measured by Pratt dilators. Secondary outcomes were the proportion of subjects needing further manual dilation, difficulty of dilation, duration of the procedure, blood loss, and side effects. Results: The vaginal-Misoprostol group had a significantly greater mean dilation (28.0 mm) than the oral Misoprostol group (24.2 mm; P Conclusion: Vaginal Misoprostol is superior to oral Misoprostol and is an acceptable alternative to laminaria tents for cervical dilation before surgical abortion in pregnancies of 7–14 weeks’ gestation. It is inexpensive and easy to administer, and achieves equal or greater dilation with less pain on insertion and no increase in side effects compared with laminaria.
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A randomized controlled trial of laminaria, oral Misoprostol, and vaginal Misoprostol before abortion ☆
Obstetrics & Gynecology, 1999Co-Authors: Laura Macisaac, Elizabeth Balistreri, Daniel Grossman, Philip D. DarneyAbstract:Abstract Objective: To compare the efficacy and acceptability of oral Misoprostol, vaginal Misoprostol, and laminaria tents for cervical dilation before surgical abortion. Methods: We conducted a randomized, double-blind, placebo-controlled trial comparing oral Misoprostol 400 μg, vaginal Misoprostol 400 μg, and one medium laminaria for dilating the cervix over 4 hours before surgical abortion. The study sample consisted of 106 women at 7–14 weeks’ gestation who presented to San Francisco General Hospital requesting abortion. The primary outcome was the amount of cervical dilation measured by Pratt dilators. Secondary outcomes were the proportion of subjects needing further manual dilation, difficulty of dilation, duration of the procedure, blood loss, and side effects. Results: The vaginal-Misoprostol group had a significantly greater mean dilation (28.0 mm) than the oral Misoprostol group (24.2 mm; P Conclusion: Vaginal Misoprostol is superior to oral Misoprostol and is an acceptable alternative to laminaria tents for cervical dilation before surgical abortion in pregnancies of 7–14 weeks’ gestation. It is inexpensive and easy to administer, and achieves equal or greater dilation with less pain on insertion and no increase in side effects compared with laminaria.
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A randomized controlled trial of laminaria, oral Misoprostol, and vaginal Misoprostol before abortion.
Obstetrics and gynecology, 1999Co-Authors: Laura Macisaac, Elizabeth Balistreri, Daniel Grossman, Philip D. DarneyAbstract:To compare the efficacy and acceptability of oral Misoprostol, vaginal Misoprostol, and laminaria tents for cervical dilation before surgical abortion. We conducted a randomized, double-blind, placebo-controlled trial comparing oral Misoprostol 400 microg, vaginal Misoprostol 400 microg, and one medium laminaria for dilating the cervix over 4 hours before surgical abortion. The study sample consisted of 106 women at 7-14 weeks' gestation who presented to San Francisco General Hospital requesting abortion. The primary outcome was the amount of cervical dilation measured by Pratt dilators. Secondary outcomes were the proportion of subjects needing further manual dilation, difficulty of dilation, duration of the procedure, blood loss, and side effects. The vaginal-Misoprostol group had a significantly greater mean dilation (28.0 mm) than the oral Misoprostol group (24.2 mm; P < .05) and a greater mean dilation than the laminaria group (25.9 mm), although this difference did not reach significance. Women who received laminaria reported significantly more pain at the time of placement (85.7% reported at least "a little" pain) compared with women who received Misoprostol by either route (28.9% of oral-Misoprostol and 34.0% of vaginal-Misoprostol subjects reported "a little" pain; P < .01). The proportion of subjects who required further manual dilation, ease of dilation, duration of the procedure, and blood loss were not significantly different among the groups. There was no difference in side effects during the 4-hour waiting period among the three groups, and gastrointestinal side effects were rare in all groups. Vaginal Misoprostol is superior to oral Misoprostol and is an acceptable alternative to laminaria tents for cervical dilation before surgical abortion in pregnancies of 7-14 weeks' gestation. It is inexpensive and easy to administer, and achieves equal or greater dilation with less pain on insertion and no increase in side effects compared with laminaria.
Philip D. Darney - One of the best experts on this subject based on the ideXlab platform.
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a randomized controlled trial of laminaria oral Misoprostol and vaginal Misoprostol before abortion
Obstetrics & Gynecology, 1999Co-Authors: Laura Macisaac, Elizabeth Balistreri, Daniel Grossman, Philip D. DarneyAbstract:Abstract Objective: To compare the efficacy and acceptability of oral Misoprostol, vaginal Misoprostol, and laminaria tents for cervical dilation before surgical abortion. Methods: We conducted a randomized, double-blind, placebo-controlled trial comparing oral Misoprostol 400 μg, vaginal Misoprostol 400 μg, and one medium laminaria for dilating the cervix over 4 hours before surgical abortion. The study sample consisted of 106 women at 7–14 weeks’ gestation who presented to San Francisco General Hospital requesting abortion. The primary outcome was the amount of cervical dilation measured by Pratt dilators. Secondary outcomes were the proportion of subjects needing further manual dilation, difficulty of dilation, duration of the procedure, blood loss, and side effects. Results: The vaginal-Misoprostol group had a significantly greater mean dilation (28.0 mm) than the oral Misoprostol group (24.2 mm; P Conclusion: Vaginal Misoprostol is superior to oral Misoprostol and is an acceptable alternative to laminaria tents for cervical dilation before surgical abortion in pregnancies of 7–14 weeks’ gestation. It is inexpensive and easy to administer, and achieves equal or greater dilation with less pain on insertion and no increase in side effects compared with laminaria.
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A randomized controlled trial of laminaria, oral Misoprostol, and vaginal Misoprostol before abortion ☆
Obstetrics & Gynecology, 1999Co-Authors: Laura Macisaac, Elizabeth Balistreri, Daniel Grossman, Philip D. DarneyAbstract:Abstract Objective: To compare the efficacy and acceptability of oral Misoprostol, vaginal Misoprostol, and laminaria tents for cervical dilation before surgical abortion. Methods: We conducted a randomized, double-blind, placebo-controlled trial comparing oral Misoprostol 400 μg, vaginal Misoprostol 400 μg, and one medium laminaria for dilating the cervix over 4 hours before surgical abortion. The study sample consisted of 106 women at 7–14 weeks’ gestation who presented to San Francisco General Hospital requesting abortion. The primary outcome was the amount of cervical dilation measured by Pratt dilators. Secondary outcomes were the proportion of subjects needing further manual dilation, difficulty of dilation, duration of the procedure, blood loss, and side effects. Results: The vaginal-Misoprostol group had a significantly greater mean dilation (28.0 mm) than the oral Misoprostol group (24.2 mm; P Conclusion: Vaginal Misoprostol is superior to oral Misoprostol and is an acceptable alternative to laminaria tents for cervical dilation before surgical abortion in pregnancies of 7–14 weeks’ gestation. It is inexpensive and easy to administer, and achieves equal or greater dilation with less pain on insertion and no increase in side effects compared with laminaria.
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A randomized controlled trial of laminaria, oral Misoprostol, and vaginal Misoprostol before abortion.
Obstetrics and gynecology, 1999Co-Authors: Laura Macisaac, Elizabeth Balistreri, Daniel Grossman, Philip D. DarneyAbstract:To compare the efficacy and acceptability of oral Misoprostol, vaginal Misoprostol, and laminaria tents for cervical dilation before surgical abortion. We conducted a randomized, double-blind, placebo-controlled trial comparing oral Misoprostol 400 microg, vaginal Misoprostol 400 microg, and one medium laminaria for dilating the cervix over 4 hours before surgical abortion. The study sample consisted of 106 women at 7-14 weeks' gestation who presented to San Francisco General Hospital requesting abortion. The primary outcome was the amount of cervical dilation measured by Pratt dilators. Secondary outcomes were the proportion of subjects needing further manual dilation, difficulty of dilation, duration of the procedure, blood loss, and side effects. The vaginal-Misoprostol group had a significantly greater mean dilation (28.0 mm) than the oral Misoprostol group (24.2 mm; P < .05) and a greater mean dilation than the laminaria group (25.9 mm), although this difference did not reach significance. Women who received laminaria reported significantly more pain at the time of placement (85.7% reported at least "a little" pain) compared with women who received Misoprostol by either route (28.9% of oral-Misoprostol and 34.0% of vaginal-Misoprostol subjects reported "a little" pain; P < .01). The proportion of subjects who required further manual dilation, ease of dilation, duration of the procedure, and blood loss were not significantly different among the groups. There was no difference in side effects during the 4-hour waiting period among the three groups, and gastrointestinal side effects were rare in all groups. Vaginal Misoprostol is superior to oral Misoprostol and is an acceptable alternative to laminaria tents for cervical dilation before surgical abortion in pregnancies of 7-14 weeks' gestation. It is inexpensive and easy to administer, and achieves equal or greater dilation with less pain on insertion and no increase in side effects compared with laminaria.
A A El-gaml - One of the best experts on this subject based on the ideXlab platform.
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Titrated oral Misoprostol solution versus vaginal Misoprostol for labor induction in primi gravid ladies
QJM: An International Journal of Medicine, 2020Co-Authors: I M Abdalfattah, W E Mohammed, A A El-gamlAbstract:Abstract Background It is now generally accepted that the uterine cervix plays an important role during pregnancy and labor and that it depends on an active ripening process within the cervix; which is necessary for successful labor induction. Aim of the Work to test the safety and efficacy of titrated oral Misoprostol compared to vaginal Misoprostol for labor induction in term gravid ladies. Patients and Methods This prospective, single-blinded randomized controlled clinical trial was conducted at Ain-Shams University Maternity Hospital during the period between August 2017 and August 2018. 120 pregnant women planned for induction of labor were recruited in the study according to the inclusion / exclusion criteria. Subjects included in the study were randomized into two groups: patients who received oral 200 ug Misoprostol in 200 ml water titrated over 24 hours and placebo tablets vaginally which resemble vagiprost tablets (25 microgram Misoprostol) and the second group contained pients who received vaginal Misoprostol 25microg maximum four doses, and placebo solution of 200 ml of tap water. Results titrated oral Misoprostol is as effective in promoting cervical ripening and inducing labor as intravaginal Misoprostol, oral Misoprostol has a similar maternal and perinatal safety profile to vaginal Misoprostol. Conclusion This new approach to oral Misoprostol administration was successful in minimizing the risk of uterine hyper-stimulation, which has been a feature of Misoprostol use for induction of labor, at the expense of a somewhat slower response. Oral Misoprostol has a similar maternal and perinatal safety profile compared to vaginal Misoprostol.
