Misoprostol for induction of labour: a Survey of attitude and practice in South western Nigeria
Date
2008
Authors
Fawole, A.O
ADEGBOLA, O
Adeyemi, A.S
Oladapo, O.T
Alao, M.O
Journal Title
Journal ISSN
Volume Title
Publisher
Springer-Verlag
Abstract
Background Although supported by research evidence,
misoprostol for induction of labour remains contentious.
Objective To assess perception and practice of obstetricians
regarding use of misoprostol for labour induction.
Methodology Cross-sectional questionnaire-based survey
of Senior Registrars and Consultant Obstetricians in southwestern
Nigeria.
Results One hundred and six questionnaires were completed
(52.8% Consultants; 47.2% Senior Registrars). Most respondents
(96, 90.6%) employ misoprostol for induction in both
live and dead fetuses with majority having personally prescribed
misoprostol for cervical ripening or induction of
labour (97.2 and 79.3%, respectively). Fetal tachycardia,
hyperstimulation and ruptured uterus were the commonly
reported complications. Twenty-six respondents (24.5%)
reported being aware of maternal death in relation to misoprostol
use. Only 52.9% of the respondents have protocols
guiding misoprostol use in their hospitals. More than half
of respondents administer misoprostol 50 g or higher
6 hourly. Most (92, 87.6%) believe that research evidence
backs use of misoprostol for the indication; 89.5% of
respondents support use of misoprostol. Most respondents
(90, 86.5%) disagree with the notion that misoprostol is too
dangerous for induction; only 26 respondents (25.1%) considered
oxytocin a better choice for induction; 93 respondents
(88.6%) agreed that, given cautious use, misoprostol
is safe for induction, while 86 respondents (81.9%) considered
misoprostol a cost-eVective intervention for labour
induction in developing countries. Though senior registrars
and younger consultants tended to report side eVects more
frequently than older consultants, they were more likely to
support misoprostol for induction of labour than older consultants.
This diVerences were however not statistically signiWcant
(P > 0.05).
Conclusion Misoprostol is widely utilized by obstetricians
for induction of labour in southwestern Nigeria. Fetal
and maternal side eVects are commonly experienced. We
recommend urgent adoption of evidence-based guidelines
in every unit using the drug to prevent complications
Description
Keywords
Misoprostol · Induction of labour · Prostaglandin analogue · Cervical ripening