Relevance. Prolong pregnancy cause is unknown; some risk factors like obesity and the previous history has been outlined. The risk for bad outcomes increases with the increase in the time of delivery. Intrauterine fetal death, meconium aspiration, fetal distress, oligohydramnios increased rate of caesarian section are among the complications. Timely delivery with accurate dose of Misoprostol can reduce the bad outcomes.
Misoprostol is a prostaglandin, not expensive and easy to store but with different side effect once wrongly administered. It is not indicated for obstetrics and gynecology in some countries but currently it is widely used for induction of labour.
Objectives. To assess the effect of Oral miso juice and its outcomes for labour induction in postterm cases and in premature rupture of membrane (PROM) at term.
Methods and Results. Search of registered documented files of clients at Kivulini Maternity Center for the year 2020.
Out of 2399 deliveries per year, 67 received oral miso juice due to postterm and PROM. 61 participants aged 17 to 34 years and 6 females were above 35 years of age.
Conclusion. 44 (65.7%) started active phase of labour within 24 hours and delivered. 16 (23.9 %) delivered after 24 hours of oral miso juice administration. 7 (10.4%) took more than 48 hours and delivered safely.
57 (85%) of those who received oral miso juice had SVD and 10 (15%) underwent emergency caesarian section due to a complication of Misoprostol as well since the drug can course fetal distress, meconium stained and other complications. 66 (98.5%) of all deliveries had Apgar score of >7 in the 1st minute, while 1 (1.5%) had Apgar of <7.
Out of all deliveries, only 1 (1.5%) underwent caesarian section reason being non reassuring fetal status (NRFS).
Out of all deliveries, 14 (20%) were accompanied by perineum tear of I&II degree and in 14 (20%) cases episiotomy was applied.
The weight of the babies delivered after miso juice was distributed as follows: 2.5 to 3.5 kg – 54 cases and 3.6 to 4.5kg – 13 cases. No babies were delivered with weight above 4.5 kg. Among them, 33 (49%) were male babies and 34 (51%) were female babies.
Oral miso juice is effective to achieve a safe spontaneous vaginal delivery. It is more effective than other method of induction of labour especially in developing country and in facility with limited human resources. It is possible to say that oral miso juice is the optimal regimen with less risk once in a right dose.
2. Definition of term pregnancy. Committee Opinion No. 579. American College of Obstetricians and Gynecologists. Obstetric Gynecol, 2013; 122:1139–40.
3. WHO recommendation for induction of labour 2011. http://whqlibdoc.who.int/hq/ 2011/WHO_RHR_11.10_eng.pdf
4. Abdulrahim A. Rouzi, MBChB; Nora Alsahly, MBChB; Rana Alamoudi, MBChB; Nisma Almansouri, MBChB;Nawal Alsinani, MBChB; Souzan Alkafy, et all Randomized clinical trial between hourly titrated and 2hourly static oral misoprostol solution for induction of labor. American Journal of Obstetrics&Gynecology APRIL 2017. https://www.ajog.org/article/S0002-9378(16)32169-X/pdf
5. Rajlaxmi Mundhra, Manika Agarwal. Fetal Outcome in Meconium Stained Deliveries. J Clin Diagn Res. 2013 Dec;7(12):2874-6. doi: 10.7860/JCDR/2013/6509.3781. Epub 2013 Dec 15.
6. Alfirevic Z, Aflaifel N, Weeks A. Oral misoprostol for induction of labour. Cochrane Database of Systematic Reviews 2014, Issue 6. Art. No.: CD001338. DOI: 10.1002/14651858.CD001338.pub3.
7. Bolla D, Weissleder SV, Radan AP, et al. Misoprostol vaginal insert versus misoprostol vaginal tablets for the induction of labour: a co‐hort study. BMC Pregnancy Childbirth. 2018;18:149 https://doi.org/10.1186/s12884-018-1788-z
8. Lenita Wannmacher MISOPROSTOL (Low dose for labour induction at term). https://www.who.int/selection_medicines/committees/expert/18/applications/Misoprostol_safety_review.pdf
9. Gülmezoglu AM, Crowther CA, Middleton P, Heatley E. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev. 2012;6:CD004945. https://doi.org/10.1002/14651858. CD004945.pub3. Review
10. Duro Gómez J, Garrido Oyarzún MF, Rodríguez Marín AB, de la Torre González AJ, Arjona Berral JE, Castelo-Branco C. Vaginalmisoprostol and cervical ripening balloon for induction of labor in late-term pregnancies. J Obstet Gynaecol Res 2017;43(01):87-91
This work is licensed under a Creative Commons Attribution 4.0 International License.