Study of induction of labour with oral misoprostol and its maternal and perinatal outcome

Abstract

Background: One great challenge in obstetric care is labour induction. Oxytocin has been used for labor induction since very long, but with high rates of failed induction. Oral misoprostol as an induction of labour (IOL) agent is rapidly gaining popularity in resource-limited settings because it is cheap, stable at ambient temperatures, and logistically easier to administer compared to dinoprostone and oxytocin. We aim to investigate the safety and effectiveness of oral misoprostol for induction of labour in our hospital setup. Material and Methods: Women with a singleton pregnancy in cephalic presentation and an unfavorable cervix who gave writ-ten informed consent and were fitting in the inclusion criteria were administered oral misoprostol, commencing at 25 mcg oral once every 4 hours for maximum 6 doses. The primary outcomes studied were i) the proportion of women delivering vaginally within 24 h of oral misoprostol administration, and ii) maternal and perinatal outcomes following induction with misoprostol. A retrospective Study of the data collected from September 2019 till April 2020 at Shalini Meghe Hospital and Research Centre, Wanadongri, Hingna, Nagpur was conducted where 188 women who came under the criteria were induced with misoprostol and outcomes were measured in the form of rate of normal vaginal delivery, maternal complications, and neonatal outcomes. Results: Total 188 patients were studied retrospectively. Vaginal deliveries were obtained in 65.95% of patients within 24 hours of induction. The cesarean section rate was 34.04%. The common cause of induction of labour was postdate pregnancy 49.46%. The response of patients with low bishop’s score was less with more doses required with longer induction to delivery rate and more chances of cesarean section. Conclusion: The oral misoprostol regimen for IOL described in the present study is safe, effective, and logistically feasible to administer in a resource-limited setting.