Misoprostol outpatient cervical ripening without subsequent induction of labor: a randomized trial.

Objective: To estimate the effect of outpatient administration of a single dose of vaginal misoprostol at term on the interval to delivery in women with unfavorable cervices.

Methods: Randomized, double blind, placebo-controlled trial comparing a single 25-microg outpatient intravaginal dose of misoprostol to placebo in pregnant women with Bishop scores less than 9 at 40 weeks or greater. After placement of the study medication, subjects were permitted to go into spontaneous labor unless an indication for induction developed.

Elective cesarean delivery for women with a previous anal sphincter rupture.

Objective: The purpose of this study was to evaluate elective cesarean delivery for women with a history of anal sphincter rupture.

Study Design: The effectiveness of cesarean delivery in parous women with a previous anal sphincter rupture was determined by decision analysis. The outcomes were excess cesarean deliveries and morbidity and mortality rates per prevented case of anal incontinence.