Sublingual vs Oral Misoprostol for Labor Induction

Abstract

Background: This study compares the efficacy and safety of sublingual vs oral misoprostol for induction of labor. Materials and methods: 160 women admitted for induction of labor at the Postgraduate Institute of Medical Education and Research, Chandigarh were randomized to receive 25 µg misoprostol orally 3 hourly or 25 µg sublingual misoprostol 4 hourly for labor induction. Outcome: The two groups were compared for number of women not delivered in 24 hours, misoprostol dose required, induction delivery interval, incidence of uterine contraction abnormalities, mode of delivery, side effects and neonatal outcomes. Results: Low dose of misoprostol is efficacious with both routes of administration. Majority women delivered vaginally and of them, comparable numbers in both vaginal and sublingual misoprostol groups delivered within 24 hours of induction (93.1 and 83.7%). The sublingual route is associated with a statistically significant lesser induction to delivery interval (14.8 ± 6.2 hours vs 17.67 ± 7.32 hours) and lesser requirement of oxytocin augmentation (62.5 vs 35%). The occurrence of uterine contraction abnormalities and neonatal outcome was similar in both groups. Conclusion: The low dose of 25 µg is efficacious and safe by both sublingual and oral routes. Sublingual route has lesser induction to delivery interval and lesser requirement for oxytocin augmentation.