Misoprostol for induction of labor with a live fetus

Induction of tabor is common in clinical practice. Many different medical and mechanical methods have been used, but the current gold standard is vaginal dinoprostone. Misoprostol has been used for the induction of tabor since 1987. In early studies with large misoprostol doses (e.g. 200 mu g) there were high rates of uterine hyperstimulation. Cochrane meta-analysis, however, shows that when used in tow doses it is as effective as vaginal dinoprostone and with no excess of hyperstimulation. 25 mu g vaginal misoprostol 4-hourly, 50 mu g oral misoprostol 4-hourly or 20 mu g oral misoprostol solution 2-hourly are all safe and effective regimens. Reports of uterine rupture in women with previous cesarean sections mean that it remains contraindicated in this group. (C) 2007 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.