Abstract
Objective To compare the efficacy of similar buccal and vaginal misoprostol doses for induction
of labor.
Study Design Retrospective chart review of 207 consecutive women undergoing term induction of
labor with misoprostol. Misoprostol route and dosing were collected. Time to delivery
and other labor outcomes (e.g., vaginal delivery less than 24 hours) were compared
between women receiving buccal and vaginal misoprostol.
Results There was no significant difference in time to delivery for women receiving buccal
(median 18.2 hour, 95% confidence interval [CI] = [14.9, 21.5]) versus vaginal (median
18.3 hour, 95% CI = [15.0, 20.4]) misoprostol (p = 0.428); even after adjusting for covariates (p = 0.381). Women who presented with premature rupture of membranes were more likely
to receive buccal misoprostol (92.7% received buccal vs. 7.3% received vaginal, p < 0.001). A similar number of women delivered vaginally in the buccal group (88.2%)
and vaginal misoprostol group (86.8%, p = 0.835). The proportion of women who experienced uterine tachysystole or chorioamnionitis
did not significantly differ by route of administration.
Conclusion We found no significant differences in time to delivery or other labor outcomes between
buccal or vaginal dosing of misoprostol in women undergoing labor induction at term.
Keywords
misoprostol - buccal - vaginal - labor induction - term pregnancy
