What is the most effective dose and route of misoprostol for labor induction?. Issue 6 (June 2018) - Panzer, Timothy S.
Abstract : EVIDENCE‐BASED ANSWER : The answer is unclear. Minimal differences exist among vaginal misoprostol (either <50 μg or ≥50 μg), oral tablets (≥50 μg), and oral titrated solution (<50 μg) in terms of risk of Cesarean delivery or failure to achieve vaginal delivery within 24 hours (SOR: A, meta‐analyses of RCTs). Compared with vaginal dosing, oral misoprostol has a lower risk of Apgar score less than 7 and postpartum hemorrhage, although a higher risk for meconium‐stained fluid (SOR: A, systematic review). Vaginal misoprostol at 50 μg leads to vaginal delivery 4.5 hours sooner than oral tablets at the same dose (SOR: B, RCT).