In pregnant women undergoing induction with misoprostol, is vaginal or oral dosing better?
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In pregnant women undergoing induction with misoprostol, is vaginal or oral dosing better? EVIDENCE-BASED ANSWER: Vaginal and oral misoprostol are comparable in pregnant women undergoing third trimester induction of labor as far as the outcomes of vaginal delivery not achieved in 24 hours, caesarean section, serious neonatal morbidity or perinatal death, and serious maternal morbidity or death. Vaginal misoprostol is associated with higher rates of postpartum hemorrhage and lower 5-minute Apgar scores than oral (SOR: B, based on systematic review of quality RCTs). The World Health Organization (WHO) recommends either low-dose vaginal or oral misoprostol for induction of labor at term for women who have not had a previous cesarean section; while the American Congress of Obstetricians and Gynecologists (ACOG) recommends oral over vaginal misoprostol (SOR: C, evidence-based guidelines).
Evidence-based practice 20, no. 1 (2017): 12-13