COMPARISON OF ORAL (20 µG 2 HOURLY) VERSUS VAGINAL (25 µG 6 HOURLY) MISOPROSTOL FOR INDUCTION OF LABOUR IN TERM PREGNANCIES

Abstract

Objective: To compare the outcome of oral misoprostol (20µg 2 hourly) with vaginal misoprostol (25µg 6hourly) for induction of labour in term pregnancies, in terms of frequency of vaginal delivery and cesarean section. Study Design: Randomized clinical trial. Place and Duration of Study: Department of Gynecology and Obstetrics, Unit II, Maternal and Child Health Centre, Pakistan Institute of Medical Sciences, Islamabad from, Jan to Dec 2015. Subjects: All pregnant women at term (>37 weeks gestation) with obstetric and medical indication for induction of labour and having Bishop Score ≤6 were included in this study. Parity ≥4, previous history of obstetric and gynecological surgery and suspected cephalopelvic disproportion were excluded. Material and Methods: The study was conducted after approval from the ethical committee of the hospital. The subjects fulfilling inclusion criteria were enrolled after informed consent. The women randomized to group A received 20 ug oral misoprostol 2 hourly orally up to a maximum of 12 doses and the women randomized to group B received 25 micro-grammisoprostol vaginally and was repeated at 6 hours interval upto a maximum of 4 doses. Randomization was done using lottery method. Data was entered on predesigned proforma and was analyzed using SPSS version 10. Results: Ninety five women were randomly assigned to group A or B. In oral misoprostol group, 91 (95.8%) had vaginal delivery and 4 (4.2%) women needed C-section compared to 379 (83.2%) vaginal delivery and 16 (16.8%) women need C section in vaginal misoprostol group (p-value0.004). Conclusion: It is concluded that women randomized to oral misoprostol had better obstetrics outcome as compared to vaginal misoprostol.

Keywords

• induction of labour
• oral and vaginal route