الفهرس | Only 14 pages are availabe for public view |
Abstract The aim of this work is to evaluate the use of misoprostol as a cervical ripening agent and to report the changes that occur in the cervix using it by different routes of administration (oral, sublingual and vaginal). Conclusion: 1- Misoprostol is an inexpensive, easily stored, easily administrated and powerful uterotonic agent. 2- The cervical changes that occur with misoprostol for induction of labour or less similar to these with spontaneous onset labour, this gives the advantage of its use for induction of labour regardless to the status of the cervix (Bishop score). 3- If the drug is given with the recommended dose in this study it can be considered safe in primigravida; however it is use in multipara should be with great care, this is to prevent the occurrence of precipitate labour which may result from the rapid progress of labour and lead to vaginal and perineal tears and postpartum haemorrhage. 4- Prolonged labour associated with misoprostol induction may predispose to a tonic postpartum haemorrhage. All preparations to prevent and promptly treat PPH have to be in the mind of the attendant with all preparation ready to use including cross matched blood. 5- There were no cases of rupture uterus in this study while its incidence in some reports in higher than usual incidence, therefore good selection of cases for induction of labour with misoprostol especially multi gravida is mandatory. Cases with CPD (whether absolute or relative), high parity, scarred uterus, mal presentation and position should be avoided to prevent the occurrence of rupture uterus. 6- Fetal distress due to hyper stimulation caused by the drug is not common, however continuous fetal heart monitoring is advised when misoprostol is used to induce labour. |