The Use of Misoprostol for Induction of Labour in a Low-Resource Setting
AbstractContext: Several studies have been done on the effect of misoprostol on the pregnant uterus. These have generally been in well-endowed hospitals that can afford cardiotocographs, intrauterine monitors, scalp electrodes and related items of equipment. Similar studies are needed in settings that would benefit best from the cheapness and stability of the drug
Objective: To assess the efficacy and safety of misoprostol for induction of labour in a health care facility with limited resources.
Study Setting and Subjects: An observational descriptive study at Korle Bu Teaching Hospital, Accra, Ghana on one hundred and sixty patients requiring induction of labour.
Methods: One hundred and sixty women had labour induced using 50µg of misoprostol inserted vaginally at four hourly intervals. The patients were monitored with the standard clinical tools, including intermittent auscultation with the Pinard stethoscope.
Results: Eighty-three percent of the women had vaginal deliveries while the remainder had caesarean sections for various obstetric indications. Patients who had uterine stimulation for premature rupture of membranes (PROM) responded very well to misoprostol, with majority requiring only a single 50µg dose to go into active labour. Women with sickle cell disease showed no adverse effect to misoprostol responded in a manner similar to the normal population.
Conclusion: We have confirmed that misoprostol can be used safely for induction of labour in settings where there are no items of sophisticated monitoring equipment. Patients with sickle cell disease and premature rupture of membranes can have successful labour induction with misoprostol with no adverse effect.
Key Words: Misoprostol, Labour Induction, Intrapartum Monitoring
[Trop J Obstet Gynaecol, 2002, 19: 78-81].
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