Washington (H24N). A drug derived from a substance in the body that stimulates the uterus is able to safely prepare a pregnant woman's cervix for delivery, according to a new study.

Although misoprostol or prostaglandin E1 has already been analyzed in controlled studies, researchers at the Sacred Heart Medical Center in Eugene, Ore., wanted to see how well it performed "when adopted into a community setting." The results from the study that involved a review of 455 patients' charts are published in the September issue of the Southern Medical Journal.

By using misoprostol as a cervical "ripening agent," the researchers found that it shortened delivery time, and reduced the need for increasing the level of the hormone oxytocin, which is responsible for inducing labor contractions. Misoprostol accomplished this, report the researchers, without increasing the incidence of cesarean section.

"Misoprostol was associated with a shorter time to delivery without a higher cesarean section rate in the community setting but with a lower rate of spontaneous labor without the need for oxytocin augmentation," writes Vern Katz, MD, and his colleagues at the Sacred Heart Medical Center.

To encourage cervical dilation (opening of the uterus into the birth canal) and effacement (a thinning of the cervical walls to ease delivery), the researchers used an initial dose of 25 mcg to 50 mcg of misoprostol every four hours until the patients' cervixes were dilated to 3 centimeters and were 75 percent effaced. Researchers gave the drug to 254 women, while another 144 received prostaglandin E2 or dinoprostone.

Multiple gestation, unexplained vaginal bleeding and abnormal presentation at the time of labor were a few of the things doctors watched out for before giving any of the women misoprostol.

More of the women (85 percent) who were given misoprostol delivered their children vaginally than those who received dinoprostone (72 percent). The mean time from beginning of contractions to delivery for women who were treated with misoprostol was seven hours and 30 minutes, compared to a mean time of seven hours and 55 minutes with dinoprostone.

Complications associated with misoprostol included nausea, fetal distress, vomiting and hyperstimulation affecting the fetal heart rate. Despite these complications, all of the mothers and infants treated with misoprostol were discharged from the hospital in excellent condition, said Katz.

"Misoprostol was found to be a safe and effective agent for cervical ripening as part of labor induction," the researchers conclude.

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