The MisoPROM study: A multicenter randomized comparison of oral misoprostol and oxytocin for premature rupture of membranes at term

Ellen Mozurkewich, Julie Horrocks, Suzanne Daley, Paul Von Oeyen, Melissa Halvorson, Mary Johnson, Michael Zaretsky, Mitra Tehranifar, Lucy Bayer-Zwirello, Alfred Robichaux, Sabine Droste, Garry Turner

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

OBJECTIVE: This study was undertaken to determine whether induction of labor with oral misoprostol will result in fewer cesarean deliveries than intravenous oxytocin in nulliparous women with premature rupture of membranes at term. STUDY DESIGN: Three hundred five women at 10 centers were randomly assigned to receive oral misoprostol, 100 μg every 6 hours to a maximum of two doses or intravenous oxytocin. The primary outcome measure was cesarean deliveries. Secondary outcomes were time from induction to vaginal delivery and measures of maternal and neonatal safety. RESULTS: The study was stopped prematurely because of recruitment difficulties. We present the results for the 305 enrolled women. There was no difference in the proportion of women who underwent cesarean delivery (20.1% in the misoprostol group, 19.9% in the oxytocin group). The time interval from induction to vaginal delivery was also similar (11.9 hours for the misoprostol group, and 11.8 hours for the oxytocin group). Maternal and neonatal safety outcomes were similar for the two treatments. More infants born to women in the misoprostol group received intravenous antibiotics in the neonatal period (16.4% vs 6.9%, P = .01), although there were no differences in chorioamnionitis or in proven neonatal infections. Women receiving misoprostol were less likely to have postpartum hemorrhage than those receiving oxytocin (1.9% vs 6.2%, P = .05). CONCLUSION: Oral misoprostol does not offer any advantage in time from induction to vaginal delivery or risk of cesarean section.

Original languageEnglish (US)
Pages (from-to)1026-1030
Number of pages5
JournalAmerican journal of obstetrics and gynecology
Volume189
Issue number4
DOIs
StatePublished - Oct 2003

Keywords

  • Misoprostol
  • Oxytocin
  • Premature rupture of membranes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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