Evaluating misoprostol and machinal methods for induction of labour – RCOG Scientific Impact Paper No. 68 – April 2022

Question 1

What % of births are induced in the UK?

Answer 1

30%

Question 2

Misoprostol how long until peak dose
- Oral/sublingual
- Buccally/vaginally

Answer 2

• Oral/sublingual: 30 mins
• Buccally/vaginally: 70-80 mins

Question 3

Misoprostol half life
- oral
- vaginal

Answer 3

• oral 20-40mins, duration 2 hours
• vaginal 4 hours
• S/L 3 hours

Question 4

How does misoprostol compare to dinoprostone?

Answer 4

Misoprostol has lower rates of CS and hyperstimulation

Question 5

Impact of mechanical inductions vs miso?

Answer 5

Similar rates of vaginal birth
Balloon 65% less risk of hyper stimulation + fetal heart changes, 52% less risk neonatal morbidity & death

Question 6

Risk of uterine rupture with prostaglandin induction?

Answer 6

1.2%

Question 7

What does of misoprostol is given for IOL at term?

Answer 7

PO 25mcg 2 hourly
Vaginal 25mcg 4-6 hourly