Best Time to Start Induction in Term Pregnancies with Misoprostol. Evaluate Early Vs Late Induction and the Mode of Delivery

The magic drug/tablet /pill (Misoprostol/ Cytotec) that is used mostly in the Caribbean islands for induction has increased drastically, fifty 50 mcg makes wonders in term pregnancy 37weeks -41 weeks.Most induction should start early as possible for a more favourable outcome (e.g.6am) Statistics shown that early induction and closely monitoring plays a vital role for a better delivery decision for mother and her unborn child.It saves time for the health care workers to manage than via an emergency.After misoprostol is inserted, the woman would have to lay for 2 two hours in the supine position and have pre and post ctg (cardiotocography) done.Given that the process takes a few minutes to insert usually 30 minutes to 1 hour if effective, the patient should report pain or some sort of tightening.The procedure (insertion of misoprostol) can be done about 2-3 times if not effective, the management should be reviewed by the attending ob./gyn and the nurse midwife.Labour of induction is frequently indicated in women with an unfavourable cervix (bishop score <=4), with up to half of all induced labour requiring cervical ripening, prostaglandins have been utilized to increase induction success and achieve vaginal delivery.Has been used off label for over thirty years as a labour induction agent.The challenge is to provide this medication with the correct dosing for this induction and with the ability to discontinue the medication if needed, all while ensuring essential maternal and neonatal safety.