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Baixa dose de misoprostol sublingual (12,5 μg) para indu??o do parto

DOI: 10.1590/S0100-72032012000400005

Keywords: labor, obstetric, labor, induced, misoprostol [administration & dosage], administration, sublingual, multicenter study, clinical trial.

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Abstract:

purpose: to describe the maternal and perinatal outcomes after the use of 12.5 μg of sublingual misoprostol for labor induction in women with term pregnancy and a live fetus. methods: we conducted a multicenter, open and non-randomized clinical trial during the period from july to december 2009. we included 30 pregnant women with an indication for labor induction at term, carrying a live fetus, with a bishop score of six or less, cephalic presentation, estimated fetal weight of less than 4,000 g and an amniotic fluid index greater than five. we excluded women with a previous uterine scar, non-reassuring fetal status, congenital anomalies, multiple pregnancy, intrauterine growth restriction, genital bleeding, and contraindications of vaginal delivery. a tablet of 12.5 μg sublingual misoprostol was administered every six hours, until the beginning of labor, with the maximum of eight doses. results: labor was successfully induced in 90% of pregnant women. the mean interval between the first dose and the onset of uterine contractions and delivery was 14.3±11.7 hours and 25.4±13 hours, respectively. the frequency of vaginal delivery was 60%. uterine tachysystole occurred in two pregnant women, being reversed in both cases without the need for cesarean section. meconium-stained amniotic fluid was observed in four patients, and an apgar score of less than 7 at five minutes in only one newborn. conclusion: maternal and perinatal outcomes were favorable after induction of labor with sublingual misoprostol at a dose of 12.5 μg every six hours. however, controlled trials are needed to compare this regimen with other doses and routes of administration.

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