EFFECT OF ORAL MISOPROSTOL ON INDUCTION OF LABOR: PILOT STUDY

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The purpose of this pilot study is to gain preliminary data on the effectiveness of various doses of oral misoprostol in inducing labor in preparation for a randomized trial of oral versus vaginal misoprostol for labor induction. This study will be observational in nature nad involve administration of oral misoprostol a PGE analogue to three groups of 10 women between 35-42 weeks' gestation requiring induction of labor. With each group of women, the drug dosage will escalate from 25 mcg q 4 hours to 50 mcg q 4 hours to 75 mcg q 6 hours. The length of induction, incidence and reason for cesarean delivery, and rates of uterine hypercontractility, fetal bradycardia, treatment for hyperstimulation and varius acute neonatal outcomes will be measured. During the first four to six hours after the initial drug administration, maternal serum will be sampled to determine the bioavailability curves for each regimen. The regimen for the follow-up study will be chosen based on efficacy of labor induction balanced with rates of treated uterine hyperstimulation.