Introduction: Misoprostol is a prostaglandin E1 analogue. During the last 8 years it has been examined in clinical trials in obstetrics for the induction of labor and cervical ripening.
Aim: To review the current literature concerning its efficacy, safety and dosage for induction of labor.
Materials and methods: This review is based on the results of 33 articles published during the years 1993-2001. Data was gathered by searching the internet at Pubmed, Medline and the list of references in the relevant articles.
Results: Misoprostol is a highly effective medication for the induction of labor in comparison to prostaglandin E1 or oxytocin. It is stable for years and the cost of treatment is low. Its disadvantage is based on its tendency to evoke increased uterine activity such as tachysystole and hyperstimulation and the fear of uterine rupture. These disadvantages can be overcome by safety measures such as decreasing the dose, increasing time intervals between doses and careful selection of patients.
Conclusions: Misoprostol is an important and efficient medication in obstetrics for cervical ripening and induction of labor. Therefore, we believe it is appropriate to start clinical trials in Israel too.