Document Detail

Vaginal misoprostol administration for cervical ripening and labor induction.
MedLine Citation:
PMID:  16885668     Owner:  NLM     Status:  MEDLINE    
Intravaginal misoprostol has been shown to be an effective agent for cervical ripening and induction of labor. Vaginal application of misoprostol has been reported in over 9000 women worldwide and seems to have safety profile similar to that of endocervically and intravaginally administered dinoprostone. Concern arises with the use of higher doses of intravaginal misoprostol (50 mcg or more) and the association with uterine contractile abnormalities and for this reason, use of low-dose misoprostol regimen has been recommended by the American College of Obstetricians and Gynecologists. The recommendation is use of a 25-mcg dose of misoprostol inserted into the posterior vaginal fornix and repeated every 3 to 6 hours as needed. Misoprostol administration to women with prior cesarean births seems to increase the likelihood of uterine scar disruption and should not be used in these women. There are reports of uterine rupture in women with unscarred uteri treated with vaginally applied misoprostol. Therefore, all patients need to be monitored adequately after misoprostol administration. Although there is a growing body of data regarding the ambulatory use of intravaginal misoprostol for cervical ripening, its use for this purpose cannot be recommended outside of investigational protocols at this time because of concerns for maternal and neonatal safety.
Deborah A Wing; Cecilia A Lyons Gaffaney
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical obstetrics and gynecology     Volume:  49     ISSN:  0009-9201     ISO Abbreviation:  Clin Obstet Gynecol     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-03     Completed Date:  2006-10-27     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0070014     Medline TA:  Clin Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  627-41     Citation Subset:  IM    
Division of Maternal-Fetal Medicine, Department of Obstetrics-Gynecology, University of California, Irvine, School of Medicine, Irvine, California, USA.
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MeSH Terms
Administration, Intravaginal
Ambulatory Care
Cervical Ripening / drug effects*
Cesarean Section
Dose-Response Relationship, Drug
Drug Labeling
Fetal Membranes, Premature Rupture / drug therapy
Labor, Induced / methods*
Misoprostol / administration & dosage*,  adverse effects,  pharmacokinetics
Oxytocics / administration & dosage*,  adverse effects,  pharmacokinetics
Reg. No./Substance:
0/Oxytocics; 59122-46-2/Misoprostol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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