Compared with oxytocin, caesarean sections and epidural analgesia were reduced with misoprostol. Lower doses of misoprostol compared to higher doses did not show significant differences except for more need for oxytocin augmentation and less uterine hyperstimulation, with and without fetal heart rate changes. Information on women's views is conspicuously lacking. The studies were not large enough to exclude the possibility of rare but serious adverse effects, particularly uterine rupture, which has been reported anecdotally following misoprostol use in women with and without previous caesarean section. The authors request information on cases of uterine rupture known to readers.
Further research is needed to establish safety.
This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. Update Software Ltd. All rights reserved.