Low-dose vaginal misoprostol for induction of labor with a live fetus.

OBJECTIVE To test the effectiveness and safety of low-dose vaginal misoprostol for induction of labor with a live fetus. METHODS Labor was induced in 666 pregnant women with a live fetus in the cephalic position, who had no medical complications and no history of uterine surgery. One-fourth of a 200-micrograms tablet of misoprostol (50 micrograms) was placed in the posterior vaginal fornix every 12 h for a maximum of four doses or until active labor commenced. Time from induction to delivery, side effects and neonatal outcome were evaluated. RESULTS Labor was successfully induced in all cases. The mean time from induction to delivery was 10.4 h. The cesarean section rate was 7.8%. There were eight perinatal deaths, six of which occurred in low birth weight fetuses. There was one case of abruptio placenta, which was less than that expected in the study population. CONCLUSION Vaginal misoprostol, in very low doses, was a remarkably efficient and safe method for induction of labor with a live fetus.