Up to date on oral misoprostol for induction of labour: an expert opinion on its use in Italian clinical practice

ABSTRACT

Labour induction (IOL) is a standard practice in obstetrics, with the aim to facilitate the initiation of labour for obstetrical, maternal, or foetal indications. Among pharmacologic agents, oral misoprostol has emerged as a leading choice due to its efficacy, safety, compliance, and good outcomes compared to other methods. Recent meta-analyses have demonstrated the benefits of low-dose oral misoprostol (≤50 mcg) in reducing caesarean delivery rates while maintaining a favourable safety profile. Clear indications about monitoring and a systematic guideline about the use of this drug do not exist yet. This article presents a comprehensive overview of the clinical evidence, expert recommendations, and practical applications of oral misoprostol for IOL, with a particular focus on dosing protocols, monitoring strategies, combination with mechanical methods and women’s opinion about the method.