Efficacy and Safety of Misoprostol Vaginal Insert to Induce Labor beyond 40 + 0 Weeks of Gestation

Objective: Misoprostol vaginal insert (MVI) is proven to induce labor by a continuously release of PGE1. Previous reports showed that MVI reduced induction delivery time as well active but it also increased uterine tachysystole. Here we attempted clarify whether safe and efficient for women with pregnancies >40 weeks in single institute. Methods: This study was performed Lutheran Hospital Bergisch Gladbach, Germany 2014-2019. A total 304 between 40 + 0 42 underwent MVI. Outcomes were: 1) maternal: from insertion delivery, interventions, mode tachysystole, 2) neo-natal: cord blood pH, APGAR scores, admission neonatal clinic. ended unexpectedly due the withdrawal (MisodelTM) September 2019. Results: 75.7% (n = 230) gave birth within 24 hours after placement. 72.2% 140) nulliparous 81.8% 90) parous delivered hours. In two cases emergency CS required. 67.8% 206) vaginal. 2.3% 7) pH levels were below 7.10. 3.3% 10) newborns transmitted Conclusion: an method pregnant beyond weeks. However, considering various complications observed (uterine tachysystole fetal distress leading high number CS), cannot universally advocate use