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Randomized trial of vaginal misoprostol, a prostaglandin analog, plus oxytocin for induction of labor in nulliparous women.
The purpose of this study was to compare the efficacy and tolerance of vaginal misoprostol (m-Miso) and oxytocin in inducing labor in nulliparous women. Healthy nulliparous women with a cervical dilatation of 3-5 cm, after 37 weeks’ gestation with unfavourable cervix were studied. The protocol randomised women to receive either 100 microg of m-Miso or 2 IU of oxytocin for induction of labor. The primary outcome was the time to delivery within 72 h. Analyses were by intention-to-treat and time-to-event. A total of 16 women were assigned to the m-Miso group and 15 to the oxytocin group. The median time-to-delivery was significantly shorter in the oxytocin group (m-Miso 12 h, oxytocin 15 h, p=0.006). The overall rate of cesarean deliveries was higher in the m-Miso group (12.5%) than in the oxytocin group (p=0.03). Vaginal misoprostol is an acceptable alternative to oxytocin for induction of labor in nulliparous women. Its use leads to a shorter time to delivery and a higher rate of cesarean section.Somatic mutations of the human C-erbB-2 protoonc