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Abstract

 Introduction: To compare the efficacy and safety of 25g vs. 50g of intravaginal (Posterior fornix) misoprostol for induction of labor in 100 patient from Jan 2012 to Dec 2012 at Lumbini Medical College.
 
 Methods: One hundred pregnant lady requiring induction were randomly assigned to receive either 25 g (group A=50) or 50 g (group B=50) of intra vaginal misoprostol every 4 hrs till adequate contractions were achieved or maximum dose of 150 g was used.
 
 Results: The onset of contraction was earlier in group B in 34 cases as compared to group A, where only 25 cases had earlier contraction ( P> 0.05). 38 cases (76%) in Group B and 35 cases (70%) in Group A delivered vaginally. Induction to delivery interval was shorter(<12hrs) in group B in 15 cases and in 10 cases in group A. Mean dose of Misoprostol (94micrograms) for successful induction in group B was high compared to Group A (75.5 microgram). Requirement for oxytocin infusion was higher in group A, 26% vs. 15%. Abnormal contractility pattern was seen in B group 24% cases compared to 14% cases in Group A. APGAR score < 7 at 1 min was seen in 26% neonates in Group B and in only 10% neonates in Group A. Ruptured uterus did not occur in any group.
 
 Conclusion: 50 g dose of misoprostol is more efficacious than 25 g dose as seen in our study. However it appears to be less safe both for mother and baby due to the high incidence of tachysystole, hyperstimulation and intrauterine passage of meconium.
Highlights
To compare the efficacy and safety of 25g vs. 50g of intravaginal (Posterior fornix) misoprostol for induction of labor in 100 patient from Jan 2012 to Dec 2012 at Lumbini Medical College
The study duration was of 1 year and it was approved by the ethical committee of the hospital (Lumbini Medical College).Women with singleton pregnancy at 37 or more weeks of gestation were included after informed consent
The Induction to delivery interval was shorter in Group B as shown in Table 1.There was no difference between the both group with respect to mode of delivery 35 cases (70%) in group A and 38 cases (76%) in
Summary
To compare the efficacy and safety of 25g vs. 50g of intravaginal (Posterior fornix) misoprostol for induction of labor in 100 patient from Jan 2012 to Dec 2012 at Lumbini Medical College. Mean dose of Misoprostol (94micrograms) for successful induction in group B was high compared to Group A (75.5 microgram). Conclusion: 50 g dose of misoprostol is more efficacious than 25 g dose as seen in our study. It appears to be less safe both for mother and baby due to the high incidence of tachysystole, hyperstimulation and intrauterine passage of meconium. This study was planned to compare the efficacy and safety of 25g vs 50g intravaginally misoprostol for induction labour. Journal of Lumbini Medical College. 2013;1(1):46-7. doi:10.22502/ jlmc.v1i1.14
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