A CLINICAL COMPARATIVE STUDY BETWEEN MISOPROSTOL (PGE1) AND DINOPROSTONE (PGE2) FOR INDUCTION OF LABOUR AT TERM - A PROSPECTIVE RANDOMISED CONTROLLED TRIAL

Abstract

Background: Comparative study beween misoprostol and dinoprostone for induction of labour at term has been done at various centres which showed misoprostol to be more effective. This study was done, 18 years back in 2001, when the most common method of induction was dinoprostone. Since then both the drugs has been used equally for induction of labour at term. But in recent past, PGE1 is not being used widely because of fear of untoward effect. Hence, the importance this article which shows misoprostol to be more effective with less side effects, easy for storage and low cost. This study is to compare the effectiveness between the two molecules of prostaglandins PGE1 and PGE2 for induction of labour in term. The complication can be reduced by proper selection, 1 to 1 and continuous fetal monitoring.
 Methods: It was a prospective RCT. 200 Women at term in whom induction of labour was indicated with no contraindications for the use of prostaglandin attending labor room in a tertiary care centre (SAT Hospital Government Medical College Trivandrum) for a period of five months, from September 1St 2000 to January 31st 2001 was chosen to compare the effectiveness of Misoprostol and Dinoprostone for induction of labour at term. Both the groups were comparable in age, parity and bishop score.
 Results: Among 200, 123(61%) were primigravida and 146 (73%) were in the age group of 21 – 30 yrs. Median induction delivery interval was about 9 hrs shorter in PGE1 group. Only14.14% required oxytocin augmentation in PGE1 Group compared to 50.54% in PGE2 group. There was 8 failures in PGE2 and there was one case of hyper stimulation in PGEI group for which LSCS was done. PGE2 costs 10 times more than PGE1.
 Conclusion: Misoprostol is faster acting with low induction delivery interval and requirement for oxytoccin augmentation. Misoprostol is low cost drug, affordable to most of our patient from low socio economic status.
 Keywords: Term pregnancy, Tab Misoprostol, PGE1, Dinoprostone gel, PGE2, Induction of labour.