Induction of labour with misoprostol - A prostaglandin E1 analogue

Abstract

The purpose of our study was to compare the safety and efficacy of intravaginal misoprostol versus existing hospital protocol of intracervical dinoprostone and oxytocin for cervical ripening and induction of labour. 200 patients with indication for induction of labour were randomly assigned to receive either intravaginal misoprostol or dinoprostone/oxytocin combination. In first group twenty five micrograms of misoprostol was placed intravaginally every 6 hours till the patient reached active stage of labour. In second group dinoprostone gel 0.5 mg was placed in the endocervix at night and oxytocin induction was started in the early morning. The average interval from start to induction of vaginal delivery was shorter in misoprostol group (1315±811 minutes) compared to dinoprostone/oxytocin group (1512±712 minutes) (p<0.01). There was no significant difference in route of delivery. 18% of misoprostol treated patients and 23% of dinoprostone/oxytocin treated patients required Caesarean section. Complications such as uterine tachysystole were significantly higher in misoprostol group (p < 0.01) but it was not associated with increased incidence of uterine hyperstimulation. Perinatal outcome was similar in both groups.