A STUDY OF VAGINAL MISOPROSTOL TABLET VERSUS INTRACERVICAL DINOPROSTONE FOR INDUCTION OF LABOUR
Background:Induction of labour is the process of initiating the labour by articial means post 24 weeks of gestation. This study was undertaken to compare the efcacy and safety of vaginal Misoprostol [25-50ug] with intracervical Dinoprostone gel (0.5mg) for induction of labour at term in terms of efcacy of drug, feto-maternal outcome, side effects and complications of drugs. Methods: 400 nulliparas at term admitted in the OBG ward were included in this study. They were randomly allocated to two groups A& B. Group A (200 women) received tablet Misoprostol 25 micrograms vaginally 4 hrly to a maximum of 3 doses and Group B (200 women) received Dinoprostone gel 0.5mg intracervically 6 hrly to a maximum of 3 doses. Comparison was done in terms of induction to delivery interval, rates of instrumental and LSCS delivery, need for NICU care and cost-effectiveness. ADRs, if any were documented and proper care taken. Results: The mean induction to delivery interval was less in the Misoprostol group than Dinoprostone group (12 hrs vs. 22 hrs). 82% patients delivered in the rst 24 hrs in Misoprostol group compared to 54 % patients in Dinoprostone group. Group A had a higher success rate (80% vs.75%) and also required less augmentation of labor ( 35% vs. 65%) compared to group B. Need for LSCS was also lower in Misoprostol group (13% vs. 18%). Need for instrumentation and incidence of NICU admission was similar in both groups. Misoprostol was more cost effective compared to Dinoprostone. Conclusions: The Misoprostol group had a shorter induction to delivery interval, more number of deliveries in the rst 24 hrs of induction and a reduced need of augmentation of labor with oxytocin. There was no signicant difference in the rate of caesarean section, hyper-stimulation syndrome, neonatal and maternal morbidity between the two groups. Thus, Misoprostol appears to be safer, cheaper and more efcacious alternative for induction of labor especially for non-fetal indications as compared to Dinoprostone gel.