Buccal versus Vaginal Misoprostol for Term Induction of Labor: A Retrospective Cohort Study

Objective  To compare the efficacy of similar buccal and vaginal misoprostoldoses for induction of labor. Study Design  Retrospective chart review of 207 consecutive women undergoing term induction of labor with misoprostol. Misoprostolroute and dosing were collected. Time to delivery and other labor outcomes (e.g., vaginal deliveryless than 24 hours) were compared between women receiving buccal and vaginal misoprostol. Results  There was no significant difference in time to delivery for women receiving buccal (median 18.2 hour, 95% confidence interval [CI] = [14.9, 21.5]) versus vaginal(median 18.3 hour, 95% CI = [15.0, 20.4]) misoprostol( p  = 0.428); even after adjusting for covariates ( p  = 0.381). Women who presented with premature ruptureof membraneswere more likely to receive buccal misoprostol(92.7% received buccal vs. 7.3% received vaginal, p p  = 0.835). The proportion of women who experienced uterine tachysystoleor chorioamnionitisdid not significantly differ by routeof administration. Conclusion  We found no significant differences in time to delivery or other labor outcomes between buccal or vaginaldosing of misoprostolin women undergoing labor inductionat term.