Tehran University Medical Journal

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Background: Intravaginal misoprostol has been shown to be an effective agent forcervical ripening and induction of labor. The aim of present study was to assess the effects of adding hyoscine to vaginal misoprostol on its success rate. Methods: In a clinical trial, 74 women who were referred to undergo legal induction of labor during first pregnancy trimester in Arash Hospital, in Tehran, Iran, between March 2006 and March 2007 were enrolled, and were randomly divided in to two groups of misoprostol (400 μg/4h, vaginal) (n=37) or misoprostol (400 μg/4h, vaginal) plus hyoscine (20 mg IV) (n=37). Their complications including nausea, vomiting, fever, abdominal pain, need for analgesics, diarrhea, vaginal bleeding, decline in hemoglobin more than 3 g/dl, need for blood transfusion and failure of treatment according to the failure of induction of labor or cervical opening in 24 hours after starting treatment and the total duration of hospitalization were compared between groups. Results: There were no significant differences between groups regarding the rate of side effects like nausea, abdominal pain and vaginal bleeding. In misoprostol plus hyoscine group, the success rate in abortion was significantly higher (40.5% vs. 18.9%, p=0.04) and total duration of hospitalization were significantly lower (1.16±0.41 vs. 1.42±0.45 days, p=0.01). There was no case of fever, need for blood transfusion or significant vaginal bleeding in both groups. Conclusions: Adding 20 mg hyoscine via IV rout to vaginal misoprostol will raise the success rate in induction of abortion, and decreases the total duration of hospitalization without adding adverse effects.

Keywords: Misoprostol, hyoscine, vaginal, induction, abortion, adverse effects

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