Low-Dose Oral Misoprostol Versus Oxytocin Infusion For Induction Of Labor In Pregnant Women With Term Premature Rupture Of Membranes in China: A retrospective Nested Case-Control Study

Abstract While the use of oral misoprostol for labor induction in premature rupture of membrane (PROM) women is not prevalent in China, the main aim of this study was to validate the efficacy and safety of low-dose oral misoprostol solution compared to oxytocin infusion for labor induction in term PROM women with unfavorite cervix conditions. A retrospective nested case-control study was conducted at a tertiary general hospital in China from March 2020 to February 2024, comparing the efficacy of oxytocin infusion and oral misoprostol for labor induction in term PROM women with a Bishop score < 6. A total of 449 mothers were included, with 282 assigned to the oxytocin group and 167 assigned to the misoprostol group. The duration of total labor time was shorter in the misoprostol group. There was a markedly higher incidence of postpartum hemorrhage (PPH) and severe PPH observed in oxytocin group. Logistic regression analysis revealed that misoprostol administration demonstrated a negative relationship (aOR: 0.46; 95%CI: 0.21–0.95) with failed labor induction outcomes and occurrence of PPH (aOR: 0.49; 95% CI: 0.27–0.85). Oral low-dose misoprostol has demonstrated both safe and superior efficacy to oxytocin infusion for labor induction and may potentially reduce the incidence of failed induction and associated with a decreased risk of PPH were observed in the misoprostol group in term PROM pregnant women with unfavorable cervical condition.