To compare the efficacy and safety of oral misoprostol with prostaglandin E2 vaginal tablets for ripening of cervix and induction of labour at term. A non blinded, randomised, controlled trial.
Department of Obstetrics and Gynaecology, Pakistan Air Force Hospital, Air Headquarters Islamabad from July 2005 to January 2006. Hundred pregnant women with a singleton live pregnancy, at term [37-42 weeks] with cephalic presentation were selected for induction of labour for various indications having a Bishop's score of < or =5. These women were randomly allocated to receive either 100microgm of misoprostol orally repeated four hourly to a maximum of four doses or a 3mg PGE2 tablet vaginally repeated six hourly to a maximum of two doses. Cervical score before and after oral misoprostol and prostaglandin E2 vaginal tablets, vaginal birth within 24 hours of first prostaglandin dose, no of patients having failed induction, caesarean sections [all] , caesarean section for fetal distress and uterine hyperstimulation with associated changes in fetal heart rate. Over the period of one year 100 women were recruited for the study, 50 to the misoprostol group and 50 to the vaginal prostaglandin E2 group. There was no significant differences between the two treatment groups in the primary outcomes: improvement in bishops score in both the groups, no of patients with failed induction in both the groups misoprostol 2/50 [4%] v PGE2 3/50 [6%] , vaginal birth achieved in 24 hours misoprostol 27/50 [54%] v PGE2 29/50 [58%] , caesarean sections 14/50 [28%] v 12/50 [24%] caesarean section for fetal distress 4/50 [8%] v 5/50 [9%] ; uterine hyperstimulation with fetal heart rate changes 2/50 [4%] v none in the PGE2 group.] . Neonatal outcomes were not significantly different in the two groups. Oral misoprostol in strength of 100 microgm has similar efficacy to vaginal PGE2 tablets for ripening of cervix and induction of labour, although difference in outcomes between the two routes is not significant but data on optimal dosage regimes and safety are still lacking
Zeba Munzar ,
A comparison of oral misoprostol and vaginal prostaglandin e2 tablets for induction of Labour at Term,
Pak. Armed Forces Med. J. 2015;
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