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Am J Perinatol 2019; 36(07): 765-772
DOI: 10.1055/s-0038-1675219
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Buccal versus Vaginal Misoprostol for Term Induction of Labor: A Retrospective Cohort Study

Meredith L. Dorr
1   Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
,
Rebecca C. Pierson
1   Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
2   Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana
,
Joanne Daggy
3   Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
,
Sara K. Quinney
1   Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
2   Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana
,
David M. Haas
1   Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
2   Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana
› Author Affiliations Funding There was no funding source for this work other than internal department funds for resident research. Dr. Pierson's time as an OB-Clinical Pharmacology was supported by NIH-NIGMS: Indiana University Comprehensive Training in Clinical Pharmacology (T32GM008425).
Further Information

Publication History

30 June 2018

04 September 2018

Publication Date:
31 October 2018 (online)

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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

Note

These results were presented as a poster presentation at the 2016 Annual Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists in Washington, DC on May 15, 2016. Content is solely the responsibility of the authors. The supporting organizations had no role in data acquisition, analysis or interpretation, manuscript creation, or the decision to submit for publication.