A randomized trial of misoprostol versus extra-amniotic sodium chloride infusion with oxytocin for induction of labor

Objective: Our purpose was to compare the efficacy and safety of misoprostol and extra-amniotic sodium chloride infusion with oxytocin for induction of labor. Study Design: This randomized trial compared two methods of labor induction in women requiring cervical ripening. One hundred twenty-three women undergoing labor induction with a Bishop score ≤5 were randomly selected to receive either misoprostol, 50 μg intravaginally every 4 hours, or extra-amniotic sodium chloride infusion. The primary outcome variable was the time interval from induction to vaginal delivery. Results: Sixty-one women received extra-amniotic sodium chloride infusion and 62 women received misoprostol. The mean time interval from the start of induction to vaginal delivery was 15.0 ± 5.0 hours and 16.5 ± 7.2 hours for the extra-amniotic infusion and misoprostol groups, respectively (P , not significant). The cesarean delivery rate was not significantly different between the 2 groups (32.8% for the extra-amniotic infusion group; 19.4% for the misoprostol group). Maternal and neonatal outcomes were similar between the 2 groups. Conclusions: Both methods of induction are equally efficacious and result in similar maternal and neonatal outcomes. (Am J Obstet Gynecol 2000;182:1039-44.)