Oral Misoprostol Vs. Placebo in the Management of Prelabor Rupture of Membranes at Term

Objective: To evaluate the efficacy of oral misoprostol for the induction of labor (IOL) in women with prelabor rupture of membranes at term (PROM) and to monitor maternal or fetal complications.

Method: This randomized, placebo controlled trial was performed in a secondary referral hospital. The data of 47 patients in the misoprostol--and 49 patients in the placebo group was available for analysis. The former received 100 microg misoprostol orally, repeated once after 6 h if not in active labor, the latter received two doses of vitamin C also after a 6-h interval. The Mann-Whitney U-test was used for analysis.

Results: The median treatment to delivery interval in the misoprostol group was 7.5 h and 25 h in the placebo group (P<0.001). No significant differences were found in the incidence of abnormalities on the cardiotocograph, mode of delivery, neonatal outcome, use of antibiotics for the mothers and patient acceptability.

Conclusion: Oral misoprostol in the suggested dose is an effective and cheap alternative for IOL in patients with PROM. No adverse effects could be demonstrated.