Success rates with low dose misoprostol before induction of labor for nulliparas with severe preeclampsia at various gestational ages

J Matern Fetal Neonatal Med. 2007 Nov;20(11):825-31. doi: 10.1080/14767050701578303.


Objective: To assess the efficiency of labor induction using low dose misoprostol for cervical ripening among nulliparous patients with severe preeclampsia.

Methods: This retrospective investigation involved cases gathered from our perinatal database for nulliparous women with severe preeclampsia delivering singleton gestations between January 2002 and May 2006. After a review of 229 hospital records, we selected only those cases (N = 145) that were eligible for a trial of labor and were administered intravaginal misoprostol (25 mcg every 3 to 6 h) for an unfavorable cervix. Primary outcomes related to the success and timing of vaginal deliveries. Secondary outcomes involved maternal and neonatal morbidity rates. Statistical evaluations included Chi-square testing and regression analysis.

Results: Vaginal delivery was successful in 95 cases (65.5%). This rate increased from 55.1% in cases at <34 weeks to 68.9% in cases at between 34 and 36 weeks, and to 72.5% in those at >or=37 weeks. Most of those who delivered vaginally did so within 24 h (82 of 95 cases, 86.3%), regardless of gestational age. Vaginal delivery was associated with a shorter postpartum stay (2.5 vs. 3.2 days; p = 0.001) and with less neonatal respiratory distress (4.2% vs. 26.0%; p < 0.001).

Conclusions: Vaginal delivery within 24 h was common, with less morbidity than cesarean delivery, in this nulliparous group presenting with severe preeclampsia and an unfavorable cervix.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cervical Ripening / drug effects*
  • Dose-Response Relationship, Drug
  • Female
  • Gestational Age
  • Humans
  • Labor, Induced / methods
  • Misoprostol / administration & dosage*
  • Oxytocics / administration & dosage*
  • Parity
  • Pre-Eclampsia*
  • Pregnancy
  • Retrospective Studies
  • Treatment Outcome
  • Trial of Labor


  • Oxytocics
  • Misoprostol