Misoprostol intravaginal administrado ambulatoriamente para inducción selectiva del trabajo de parto en pacientes con embarazo a término: Estudio de cohorte

objectives: analyzing response to an outpatient intravaginal dose of misoprostol administered to low-risk, full-term pregnant patients desiring selective induction of labor. materials and methods: descriptive cohort study of 373 low-risk pregnant patients (38 or more weeks), lacking medical indication for such procedure but desiring to terminate their pregnancy who received an initial 50 mcg dose of intravaginal misoprostol as outpatients. the time taken between placing the misoprostol, initiation of labor, hospitalization time and actual labor were recorded. labor was monitored and uterine activity evaluated for detecting polysistolia or uterine hyper-stimulation and fetal state. the type of birth, the newborn, the need for transfer to a neonatal unit and maternal complications were also evaluated. results: a successful response was obtained in 308 patients (85.3%) with a single 50 mcg dose of misoprostol; success rate was 98.9% considering all 50 mcg doses. 88.3% of the patients gave birth within the first 24 hours of having been induced. vaginal birth accounted for 91.7% of the cases (74.8% eutocic and 16.9% instrumented), the rest being cesarean (8.3%). 97.3% of the newborn had an apgar score of 7 or more at one minute and 100% scored 8 or more at 5 minutes. there were no maternal complications. conclusions: using out-patient misoprostol has emerged as an alternative for inducing labor due to its effectiveness and safety. even though this was not a controlled study, the results highlighted misoprostol's important out-patient benefit which should be confirmed by randomized studies.