Stripping of membranes versus vaginal misoprostol in induction of labor

Abstract

Background The objective of this study was to evaluate the safety and efficacy of membrane stripping and vaginal misoprostol in the induction of labor in low-risk patients at term pregnancy (38–40 gestational weeks). Aim This study was done to compare the efficacy and safety of the two techniques for cervical ripening/labor induction by stripping of membranes and low-dose vaginal misoprostol on the outcome of labor induction in singleton pregnancies between 38 and 40 weeks. Patients and methods This prospective study was conducted for 9 months. The study included 100 women divided randomly into two groups: group I (n = 50) in which stripping of membranes was performed and group II (n = 50) which received intravaginal misoprostol. In group I, stripping of membranes was performed to be repeated after 48 h then followed up within 72 h of the first visit. In group II, patients received 25 μg vaginal misoprostol tablets every 6 h with a maximum of four doses after admission for follow-up of fetal well-being and observations of the route of delivery and indication of cesarean section. Time interval from the start of induction to the delivery time and need for oxytocin augmentation and labor complications were observed. Outcome data as fetal weight, Apgar scores at 1 and 5 min, and need for admission to neonatal ICU were recorded. Results Stripping of membranes is as effective as vaginal misoprostol, but the induction-delivery interval was significantly lower in misoprostol. There were no statistically significant differences between the two groups in the results of neonatal outcome. Conclusion Both methods were effective and safe in the induction of labor; however, misoprostol needs hospital admission, with no increases in the risk of neonatal outcome and minimal adverse effects.

Keywords

• induction-delivery interval
• prolonged gestation
• stripping of membranes
• vaginal misoprostol