Comparison of oral versus vaginal misoprostol for induction of labour at term

Abstract

Background: Preinduction cervical ripening has a great influence on induction of labor. For induction of labor various methods are used. Mechanical methods are Foleys catheter with or without extra-amniotic saline. Various pharmacological methods are misoprostol, dinoprostone, and oxytocin.Methods: This was a prospective observational study conducted on 100 patients with 50 patients in each group in the department of obstetrics and gynecology, Government Medical College, Srinagar from June 2020 to March 2021 over a period of 9 months. Induction with oral misoprostol or vaginal misoprostol was done in respective groups. Various parameters noted were induction delivery interval, number of doses needed, mode of delivery, and fetomaternal outcome.Results: Average number of doses of misoprostol in oral group was 3.84 and average number of doses in vaginal group was 1.90. Mean induction delivery interval in oral group was 16 hours and 10.94 hours in vaginal group. 32% patients delivered by full-term vaginal delivery (FTVD) in oral group and 18% underwent lower segment caesarean section (LSCS), while as 38% patients in vaginal group had FTVD and only 12% patients underwent LSCS.Conclusions: Our data supported the fact that induction with vaginal misoprostol can be equally effective in either oral or vaginal route. However, induction with vaginal misoprostol leads to shorter induction delivery interval compared to induction with oral misoprostol. Our study also highlighted the fact that induction with vaginal misoprostol requires lesser doses as compared to that with oral misoprostol. However, there are no significant differences in number of caesareans between the two groups. Difference in neonatal APGAR scores and maternal complications were non-significant in both the groups.