Comparative study of oral misoprostol and vaginal misoprostol in the induction of labour

Volume : VII, Issue : VIII, August - 2018

Pandurangaiah R, Leela Gr, Asokan Keloth Manapatt

Introduction: Misoprostol has been in use for cervical priming since 1979 [1]. Even though there are many

methods of induction of labour, misoprostol is the commonest medical agent used for induction of labour [2]. A

comparative study of oral misoprostol and vaginal misoprostol was conducted at Kannur Medical College during a period of two years from

2016 to 2018, in the effectiveness of induction of labor

Objectives:

1. To compare the efficacy of misoprostol and oxytocin in the induction of labor

2. To compare the complications of oral misoprostol and vaginal misoprostol

3. To compare the induction-to-active phase of labor time

4. To compare the induction-to-delivery time

5. To compare the need for oxytocin augmentation

6. To compare the failure rate

Methods: A total number of cases selected for study purpose were 150 for a period of about 2 years from 22 November 2016 to 28 July 2018.

Induction was done for various indications. Oral misoprostol group received 50 μg every four hours and vaginal insertion group received a

25 μg for every four hours. The duration between onset of induction and delivery was recorded in both groups. The onset of active phase of

labour was also noted. Maternal and fetal complications also were noted separately. Labour was monitored by partogram and cesarean

delivery were conducted in case of dysfunctional labour. Such cases were counted as failure of induction

Result : Failure of induction by misoprostol was less with oral misoprostol, 17.9% comp� to vaginal insertion which was 24.6%, with

statistical signi􀃶cance (P < 0.001). Induction-to-delivery time was shorter for oral misoprostol group (P < 0.001). Induction-to-active labor

was also shorter for oral misoprostol group (P < 0.001). Use of oxytocin augmentation in oral group was less in oral misoprostol group (p

<0.001). Complications, maternal, and fetal were similar in both groups (p 0.1) except uterine hyperstimulation which was more in vaginal

group (p <0.01). Failure rate was also less in oral misoprostol group. (p <0.001)

Conclusion: Oral misoprostol is a safe and effective method of induction of labor which is far superior to vaginal insertion of misoprostol.