A comparison of vaginal misoprostol and prostaglandin E2 for induction of labour at term

Abstract

Our objective was to compare the efficacy of vaginal misoprostol and tablet PGE2 for induction of labor at term.Methods: In this RCT a total of 140 women at term gestation were given either misoprostol (50 mcg) or prostaglandin E2 (3 mg) for induction of labour. The study was conducted at the Gynae/Obstetrics department, PAEC Hospital Islamabad, in a period of six months. All women requiring induction, having gestational age > 37 weeks, singleton pregnancy with cephalic presentation, bishop score < 6 and reassuring fetal heart rate tracing were included in the study. The study outcome was measurement of efficacy in terms of induction delivery interval, number of vaginal deliveries achieved within 24 hours, mode of delivery, total doses, need for oxytocin and number of successful inductions. Results: The mean age and average gestational age was similar in the two groups of patients. In group A (51.4%) patients required two doses while in group B (32.9%) took two doses. Similarly, (60%) patients required oxytocin in group A compared to (50%) in group B. The mean delivery induction interval was 10.8 hours (650 minutes) in group A compared to 9.01 hours (541 minutes) in group B; and this difference in two means is statistically significant. In group A (18.5%) patients required emergency cesarean section while in group B (27.1%) needed cesarean section. The major indication for emergency cesarean section in group B was fetal distress. Therefore misoprostol can play a very important role in the practice of obstetrics and gynecology in resource depleted countries where other prostaglandins are expensive and storage at low temperature is a problem.