COMPARITIVE STUDY OF 50 MCG ORAL VERSUS 25 MCG VAGINAL MISOPROSTAL ADMINISTRATION FOR INDUCTION LABOUR AT TERM

Dr.M.HINDUMATHI; Dr.B.TEJASWI PRABHANJANA; Dr KARTHIKI

Volume : VII, Issue : XII, December - 2018

COMPARITIVE STUDY OF 50 MCG ORAL VERSUS 25 MCG VAGINAL MISOPROSTAL ADMINISTRATION FOR INDUCTION LABOUR AT TERM

Dr. M. Hindumathi, Dr. B. Tejaswi Prabhanjana, Dr Karthiki

Abstract :

Background and objectives : Induction of labour is one of the most common obstetric procedures performed in the world. Among the various methods of induction of labour, the synthetic prostaglandin E1 analogue �Misoprostol� has emerged as a promising agent for induction of labour. The present study aims to assess and compare the safety and efficacy of 50 �g oral misoprostol and 25 �g intravaginal misoprostol for induction of labour at term .

Methodology : This prospective randomized comparative study included 100 pregnant women at term with obstetric or medical indications for induction of labour. Women either took 50 �g misoprostol orally or had 25 �g of misoprostol inserted in the posterior vaginal fornix. In each group, misoprostol administration was repeated every four hours in the same dose until regular uterine contractions were established or to a maximum of six doses. Induction to delivery interval, number of doses of misoprostol required, need for oxytocin augmentation, outcome of labour, maternal and fetal complications for each group were compared.

Results : The mean number of oral misoprostol doses required for induction was significantly shorter(1.78) compared to the mean number of vaginal misoprostol doses(2.9) with P=0.00002 .The mean induction to delivery interval was significantlyshorter in oral group compared to vaginal group (16.46h in oral group versus

21.38h in vaginal group with P=0.003).The percentage of cases requiring oxytocin

augmentationwas significantly more in vaginal group(76%)than oral group(42%).The improvement in Bishop score after 6 hours was also more in oral group than vaginal group. There were no significant differences between the groups with respect to mode of delivery, number of failed inductions, maternal complications and fetal outcome.

Conclusion : Oral misoprostol in dose of 50�g is as efficacious as 25�g vaginal misoprostol because of similar labour outcome with shorter induction delivery interval, smaller number of doses required for delivery, lesser requirement of oxytocin augmentation with similar maternal and fetal outcome. Oral route of administration is easy and convenient for both patients and caregivers.