The Effect of Intravaginal Misoprostol on the Duration of Labor in Preterm Premature Rupture of Membrane

Premature rupture of membrane is one of the most common problems in obstetrics, and successful labor induction, especially in cases with low bishop score(BS), is an important factor in decreasing maternal and fetal complications. The object of this study was to assess the efficacy and safety of vaginal misoprostol on duration of labor in preterm premature rupture of membrane(PPROM) cases with low BS. Patients & In this randomized controlled trial, 108 pregnant women with PPROM, gestational age of 29-37 weeks, BS≤4 and indication of pregnancy termination were randomly assigned into two groups to receive oxytocin(control) or 25µg misoprostol and then oxytocin(case). The mean induction to delivery interval was significantly shorter in the misoprostol group than oxytocin group(507.68±248.01min vs 596.66±246.38min) (P=0.005). Cesarean section rate was similar in two groups but cesarean rate due to failed induction was lower in misoprostol group than oxytocin group(9%vs19%)(P=0.004). There was no difference between two groups with regard to birthweight and 1 and 5 min apgar scores. Tachy systol was not seen in two groups. There were 2(3.7%) cases of headache (which responded to analgesic) and 3(5.5%) cases of nausea(which needed no treatment) in misoprostol group. It can be concluded that vaginal misoprostol is effective, safe, and economic in PPROM cases with low BS.