Objective: Misoprostol vaginal insert (MVI) is proven to
induce labor by a continuously release of PGE1.
Previous reports showed that MVI reduced induction to delivery time as
well as active labor time but it also increased uterine tachysystole. Here we
attempted to clarify whether MVI is safe and efficient
for women with pregnancies >40 weeks in a single institute.Methods: This study was performed in Lutheran Hospital Bergisch Gladbach, Germany
2014-2019. A total of 304 women between 40 + 0 to 42 + 0 weeks underwent labor
induction with MVI. Outcomes were: 1) maternal: time from
insertion to delivery, interventions, mode
of delivery, and uterine tachysystole, 2) neo-natal:
cord blood pH, APGAR scores, and admission to a neonatal clinic. This study ended unexpectedly due to the withdrawal of
MVI (MisodelTM) in September 2019. Results: 75.7% (n = 230) of women
gave birth within 24 hours after MVI placement. 72.2% (n = 140) nulliparous
women and 81.8% (n = 90) parous women
delivered within 24 hours. In two cases emergency CS was required. 67.8%
(n = 206) of women delivered vaginal. 2.3% (n = 7) of cord pH levels were below
7.10. 3.3% (n = 10) of newborns were transmitted to a neonatal clinic. Conclusion: MVI is an efficient method to induce labor for pregnant women beyond 40 + 0 weeks. However, considering various complications observed (uterine tachysystole
and fetal distress leading to a high
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