A comparative study of 25 mcg vs 50 mcg of vaginal misoprostol for induction of labour

Authors

  • Amika Aggarwal Department of Obstetrics and Gynecology, SGRDIMSR, Amritsar, Punjab, India
  • Sangeeta Pahwa Department of Obstetrics and Gynecology, SGRDIMSR, Amritsar, Punjab, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20181400

Keywords:

Bishop score, Induction of labor, Misoprostol

Abstract

Background: The objectives of the current study were to compare the efficacy and safety of 25μg and 50μg of intravaginal misoprostol for induction of labor at term and to study the maternal and fetal outcome.

Methods: A Prospective Study was done on 50 cases with 25μg misoprostol and 50 cases of 50μg of misoprostol intravaginal, repeated every 6 hourly till adequate uterine contractions or maximum 5 doses. Total dose of induction, induction delivery interval, mode of delivery, maternal and fetal outcome were recorded.

Results: Mean induction delivery interval was 13.8±5.9 and 14.0±5.7 hours (P=0.9) with the 25μg and 50μg misoprostol respectively. The 25μg misoprostol group had a lower delivery rate with a single dose compared with the 50μg group (38% and 42% respectively). However, 25μg group had more deliveries than 50μg group with increasing number of misoprostol doses (36% vs. 38%, and 20% vs. 16% for 2 doses and 3 doses respectively). The need for oxytocin augmentation among participants was higher in the 25μg group (20%) than in 50 μg group (16%).This was however not statistically significant (P=0.603). At lesser initial bishop score, with 50µg misoprostol less doses are needed as compared to 25 µg and hence induction delivery interval decreases. The rates of caesarean section and operative vaginal delivery were similar in both groups. There was no significant difference in maternal side effects and neonatal outcomes among the women in the two groups.

Conclusions: The 25 µg of intravaginal misoprostol administered six‑hourly appears to be as effective but safer than 50 µg for induction of labor. The use of 50 µg misoprostol may be recommended when there is a need to expedite vaginal delivery especially in cases of lesser initial bishop score.

References

Bharathi A, Kumar KA, Ganga AP. A Comparative Study of 25 mcg vs 50 mcg of vaginal Misoprostol for induction of Labour. J South Asian Feder Obst Gynae. 2013;5(3):111-5.

McMaster K, Sanchez Ramos L, Kaunitz AM. Balancing the efficacy and safety of misoprostol: a meta-analysis comparing 25 verses 50 micrograms of intravaginal misoprostol for induction of labour. BJOG. 2015;122(4):468-76.

Adebayo FO, Onafowokan O, Adewole N. A Comparison of 25 µg with 50 µg Misoprostol for cervical Ripening and Induction of Labor. J Womans Health Care. 2017;6(4):378.

Adeniyi AA, Odukogbe AA, Olayemi A, Oladokun O, Adeniji AO, Aimakhu CO, et al Randomisation of two dosing regimes of vaginal misoprostol for cervical ripening and labor induction in a low resource setting. Niger J Clin Pract. 2014:17(3):287-91.

Azubuike IJ, Bassey G, Okpani A. Comparison of 25 and 50 microgram of misoprostol for induction of labour in nulliparous women with postdate pregnancy in Port Harcourt. Niger J Clin Pract. 2015;18(2):263-7.

Vidyashree, Munikrishna M. Comparative study of 25 µg versus 50 µg of intravaginal misoprostol for induction of labor. J Clin Biomed Sci. 2013;3(3):129-32.

Ekele BA, Oyetunji JA. Induction of labour at Usmanu Danfodiyo University Teaching Hospital, Sokoto. Trop J Obstet Gynaecol. 2002;9(2):74-7.

Meydanli MM, Caliskan E, Burak F (2003) Labour induction post-term with 25 micrograms vs. 50 micrograms of intravaginal misoprostol. Int J Gynaecol Obstet. 2003;81(3):249-55.

Has R, Batukan C, Ermis H. Comparison of 25 and 50 mcg vaginally administered misoprostol for preinduction of cervical ripening and labour induction. Gynaecol Obstet Invest. 2002;53(1):16-21.

El-Sherbiny MT, El-Gharieb IH, Gewely HA. Vaginal misoprostol for induction of labour: 25 vs. 50 μg dose regimen. Int J Gynaecol Obstet. 2001;72(1):25-30.

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Published

2018-04-28

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Original Research Articles