Comparison of efficacy of PGE2 gel, Oral misoprostol and combination of foleys bulb with Oral misoprostol in predicting the Outcome of induction of labour: A randomized controlled trial

Abstract

Aim: To compare the efficacy of PGE2 gel (Prostaglandin E2 gel), oral misoprostol and combination group (Foleys bulb + oral misoprostol) in predicting the outcome of induction of labour. Materials and Methods: This prospective randomized controlled trial included 201 women requiring induction of labour. A total of 67 women were randomly allocated to PGE2 gel group, 69 women to oral misoprostol group, 65 women allocated to the combination group using computer generated allocation sequence. The primary outcomes which was analyzed in the study were time interval between induction and active phase of labour and time interval between induction and delivery. Results: The mean time interval between induction and active phase of labour was shorter with the combination group when compared with PGE2 gel group & oral misoprostol group (9hrs vs 16hrs vs 18hrs, p value 0.002). The combination group also resulted in shorter time interval between induction and delivery (16hrs vs 21hrs vs 25hrs, p value 0.014). Highest proportion of women achieved vaginal delivery within 24hrs from induction in the combination group (87% vs 71% vs 59%, p value 0.048). No significant difference were seen with maternal and neonatal outcomes. Conclusion: In our study, the combination group achieved shorter time interval between induction and active phase of labour, induction and delivery and higher proportion of vaginal deliveries within 24hrs from induction when compared to PGE2 gel and oral misoprostol without increasing labor complications. Keywords: Efficacy, Induction of labour, PGE2 gel, Misoprostol, Foleys bulb.