A comparison between the effects of oral titrated suspension of misoprostol and infusion of oxytocin for labor induction in term pregnancies.

Objectives: Comparison between the effects of oral titrated suspension of misoprostol and infusion of oxytocin for labor induction in term pregnancies. Design: Randomized clinical trial. Setting and conduct: In misoprostol group, mioprostol (synthetic prostaglandin E1 analogue) suspension (Cytotec, 200 micro-gram tablet will be solved in 200 cc of distilled water), will be administered in 20 micro-gram dosages; (20 milliliter) every 2 hours for 3 doses (total of 60 µg). Uterine contractions will be monitored during this period. If contractions are appropriate (=>3 forceful contractions with a duration of 40 seconds in 10 minutes), drug administration will be terminated. In case of inappropriate contractions, and reassuring FHR, misoprostol will be increased up to 40 µg every 2 hours until having appropriate contractions and then, administration of misoprostole will be terminated. In this group, serum with distilled water will be used for blinding the study similar to the oxitocin group. In oxytocin group, intravenous oxytocin will be infused in a dosage of 2.5 mIU per minute and will be doubled every 15 minutes until having appropriate contractions. Maximum dosage of oxytocin is 60 mIU per minute. In this group, water will be used for blinding the study similar to the misoprostole group. Participants: Inclusion criteria includes: maternal age between 20-40 years; certain gestational age between 40-42 weeks; singleton with cephalic presentation; Bishop Score of more than 5 and favorable pelvis in vaginal examination. Exclusion criteria includes: parity of more than 3; high risk pregnancy; using prostaglandins during present pregnancy and spontaneous labor. Interventions: administration of oral titrated solution of misoprostol and infusion of oxytocin. Main outcome: Number of deliveries during the first 24 hours.

Investigator.