DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20173681

Comparative study of efficacy and safety of vaginal misoprostol versus oral misoprostol in induction of labour when used in equal doses

Ambika H. E., Swathi Bhat, Lepakshi B. G., Savitha C. S.

Abstract


Background: It was a randomized controlled prospective study. A large number of women in their advanced pregnancies often need labour induction for various reasons. This study aims to evaluate a safe, effective and inexpensive mode of medical induction. The purpose of the study is to evaluate the safety and efficacy of vaginal misoprostol versus oral misoprostol in induction of labour when used in equal doses.

Methods: Two hundred patients were included in the study. They were divided into two groups of 100 patients each. One group i.e. Group A received vaginal misoprostol while the other group i.e. Group B received oral misoprostol. The dosage was 50μg every 6th hourly maximum of four doses. The progress of labour in both groups was charted on a partogram. The outcome of pregnancy, maternal and foetal outcomes were statistically analysed.

Results: When compared with respect to age, height, gestational age, indication for induction, there was no difference in either of the groups. The numbers of doses of misoprostol for successful outcome of labour in the vaginal group i.e. 2.25±0.53 was lesser than the dosage needed in the oral group i.e. 2.71±0.60 (P value M 0.0001). which is highly significant. The induction-delivery interval was also less in the vaginal group compared to the oral group. (12.90±2.40 hours versus 15±75 hours). Only 13 women in the vaginal group needed acceleration with oxytocin in contrast to 17 women in the oral group. The need for caesarean section in women induced with vaginal misoprostol was 12 women in comparison to oral group which was 32 women. No statistically significant difference was seen in neonatal outcome in either of the groups.

Conclusions: When given in equal doses the vaginal administration of misoprostol is more effective in successful induction of labour when compared to oral misoprostol.


Keywords


Labour induction, Misoprostol 50μg, Oral misoprostol, Route of administration, Vaginal misoprostol

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References


Singh TG. Clinics in obstetrics. 1st Ed. Jaypee Brothers Medical Publishers;2015:612.

Singh TG. Clinics in obstetrics. 1st Ed. Jaypee Brothers Medical Publishers;2015:613.

Miriani Neto C, Delbin AL, Júnior V. Padräo tocográfico desencadeado pelo misoprostol. Rev Paul Med. 1988;106(4):205-8.

Induction of labour, ACOG Practice Bulletin No. 107. American College of Obsetericians and Gynecologists. Obstet Gynecol. 2009:114: 386-97.

Bartusevicius A, Barcaite E, Nadisauskiene R. Oral, Vaginal and Sublingual misoprostol for induction of labour Int J Gynecol Obstet. 2005;91(1):2-9.

Zieman M, Fong SK, Benowitz NL, Banskter D, Darney PD. Absorption kinetics of misoprostol with oral or vaginal administration. Obstet Gynecol. 1997;90(1):88-92.

Fisher SA, Mackenzie VP, Davies GA. Oral versus vaginal misoprostol for induction of labor: a double-blind randomized controlled trial. Am J Obstet Gynecol. 2001;185(4):906-10.

Shetty A, Danielian P, Templeton A. A comparison of oral and vaginal misoprostol tablets in induction of labour at term. Br J Obstet Gynecol. 2001;100:238-43.

How HY, Leaseburge L, Khoury JC, Siddiqi TA, Spinnato JA, Sibai BM. A Comparison of various routes and dosages of misoprostol for cervical ripening and the induction of labor. Am J Obstet Gynecol. 2001;185:911-5.

Jindal P, Avasthi K, Bala T. A Comparison of Vaginal misoprostol versus Foley’s catheter with oxytocin for induction of labour. J Obstet Gynecol. 2006;108:1130-7.