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It is unclear if this population should receive the same dose of vaginal misoprostol for induction of labor as non\u2010obese parturient women. We investigate the influence of obesity on the pharmacokinetics and placental transfer of the metabolite misoprostol acid in parturient women. Parturient women (n = 40) were enrolled and received misoprostol 25 \u00b5g\/6 h vaginally and were allocated into two groups according to the pre\u2010pregnancy body mass index (BMI &lt;30 kg\/m<jats:sup>2<\/jats:sup> non\u2010obese, n = 18 or BMI &gt;30 kg\/m<jats:sup>2<\/jats:sup> obese, n = 22) or according to the labor induction outcome (failure [n = 10] or success [n = 30]). Blood collection for pharmacokinetic study occurred after the first misoprostol dose. The pharmacokinetic parameters obtained in non\u2010obese parturient women were not statistically different from those obtained in obese group (<jats:italic>P<\/jats:italic>\u00a0Value &gt; \u00a0.05). However, when the parturient women were grouped by the labor induction outcome, the failed labor induction group presented a higher (median [interquartile range]) BMI (44.4 [34.6\u201047.9] vs 33.7 [28.9\u201036.5] kg\/m<jats:sup>2<\/jats:sup>) (<jats:italic>P<\/jats:italic>\u00a0Value = \u00a0.0017), lower C<jats:sub>max<\/jats:sub> (11.5 [4.82\u201022.2] vs 22.8 [14.2\u201030.8] pg\/mL) (<jats:italic>P<\/jats:italic>\u00a0Value = \u00a0.0308) and not statistically different AUC<jats:sub>0\u20106<\/jats:sub> (31.8 [13.4\u201061.5] vs 53.4 [35.4\u201077.7]) pg\u2022h\/mL) (<jats:italic>P<\/jats:italic>\u00a0Value = \u00a0.0580) and t<jats:sub>max<\/jats:sub> (2.50 [1.19\u20104.25] vs 3.00 (1.88\u20105.00) h (<jats:italic>P<\/jats:italic>\u00a0Value = \u00a0.3198) when compared with parturient women who presented successful labor induction. This data suggests a higher loading dose (higher volume of distribution) and unchanged maintenance dose (unchanged AUC<jats:sub>0\u20106<\/jats:sub>) of misoprostol for this population. Further studies are required to investigate the efficacy and safety of higher misoprostol loading doses for this population.<\/jats:p>","DOI":"10.1002\/jcph.6166","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T08:43:25Z","timestamp":1732610605000},"page":"403-410","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Vaginal Misoprostol Pharmacokinetic Changes in Obese Parturient Women Who Presented Labor Induction Failure"],"prefix":"10.1002","volume":"65","author":[{"given":"Gabriela Campos de Oliveira","family":"Filgueira","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics Ribeir\u00e3o Preto Medical School University of S\u00e3o Paulo  Ribeir\u00e3o Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6986-6193","authenticated-orcid":false,"given":"Jhohann Richard de Lima","family":"Benzi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy School of Pharmaceutical Sciences University of S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4883-1332","authenticated-orcid":false,"given":"Grazielle de F\u00e1tima Pinto","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Ribeir\u00e3o Preto Medical School University of S\u00e3o Paulo  Ribeir\u00e3o Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Paula","family":"Marques","sequence":"additional","affiliation":[{"name":"Department of Clinical Analysis Food Science and Toxicology School of Pharmaceutical Sciences of Ribeir\u00e3o Preto University of S\u00e3o Paulo  Ribeir\u00e3o Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus De Lucca","family":"Thomaz","sequence":"additional","affiliation":[{"name":"Department of Clinical Analysis Food Science and Toxicology School of Pharmaceutical Sciences of Ribeir\u00e3o Preto University of S\u00e3o Paulo  Ribeir\u00e3o Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldo","family":"Duarte","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Ribeir\u00e3o Preto Medical School University of S\u00e3o Paulo  Ribeir\u00e3o Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0074-4953","authenticated-orcid":false,"given":"Vera Lucia","family":"Lanchote","sequence":"additional","affiliation":[{"name":"Department of Clinical Analysis Food Science and Toxicology School of Pharmaceutical Sciences of Ribeir\u00e3o Preto University of S\u00e3o Paulo  Ribeir\u00e3o Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Carvalho","family":"Cavalli","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Ribeir\u00e3o Preto Medical School University of S\u00e3o Paulo  Ribeir\u00e3o Preto S\u00e3o Paulo 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