English

Abstract

BACKGROUND The ability to induce and augment labour has been of keen interest to many societies from the time immemorial till date. For majority of the women, the process of labour starts spontaneously at or near term and would result in vaginal “delivery.”1 Augmentation refers to the stimulation of spontaneous contractions that are considered inadequate because of failed cervical dilatation and foetal descent5. The purpose should be to relieve the parturient from the prolonged painful and exhausting delivery process into a short time frame. We wanted to compare the efficacy of titrated oral misoprostol solution with that of IV oxytocin infusion for augmentation of labour and determine the indications for failure of the augmentation process. METHODS The present study is a randomized control trial. 200 patients requiring labour augmentation were divided randomly into two groups by the method of colour code cards that were picked by the patients themselves from November 2011 to October 2013. Titrated oral misoprostol (TOM) solution 20 ml (1 μg / ml, 20 μg total) given for one group every hourly until the contractions were adequate. If adequate contractions were not achieved even after 4 doses, then, the dose was increased to 40 μg till adequate contractions were achieved. Another group received Oxytocin IV infusion with the maximum dosing rate of 20 mill units / min. RESULTS 200 women were enrolled in the study, of whom 100 were given titrated oral misoprostol solution, and 100 were given intravenous oxytocin for labour augmentation. The main outcome of augmentation to delivery interval time was 4 hours in TOM and 4.2 hours in oxytocin group. 88 % and 85 % achieved vaginal delivery within 12 hours in TOM and IV oxytocin group respectively. 8 % and 4 % in the TOM and IV oxytocin group underwent lower segment caesarean section (LSCS) in view of failure to progress, whereas 2 % and 8 % in TOM and oxytocin group had LSCS in view of foetal distress. APGAR score was normal in both the groups. CONCLUSIONS Titrated oral misoprostol solution is as efficacious as IV Oxytocin infusion for labour augmentation. It is safe, inexpensive and easy to use. Augmentation-to-delivery interval is very much reduced with the use of titrated oral misoprostol solution and the incidence of Caesarean section is comparable to that of IV oxytocin group. KEY WORDS Tom, Oxytocin, Augmentation, Labour