- Current limitations on doses of misoprostol in second-trimester induction of labor may be unwarranted.
Why this matters
- In 2019, the American College of Obstetricians and Gynecologists (ACOG) cautioned against using more than 5 doses of misoprostol for second-trimester induction of labor.
- However, some professional organizations have questioned this number; the WHO and the International Federation of Gynecology and Obstetrics recently updated their guidelines to no longer suggest a maximum number of doses.
- No differences in rates of chorioamnionitis (P=.79), dilation and curettage for the retained placenta (P=.91), hemorrhage (P=.33), or transfusion (P=1.00) between the ≥6 and ≤5 doses groups.
- Retrospective study.
- Women undergoing induction of labor between 14 weeks 0 days and 23 weeks 6 days of gestation during 2003-2016 were identified from a delivery database.
- Women receiving ≥6 doses of misoprostol (n=78) were compared with those receiving ≤5 doses of misoprostol (n=390).
- Funding: None disclosed.
- Small numbers in the study.
- Broad range in gestational age.
- Dosage of misoprostol varied.