Intravenous Dexamethasone Versus Vaginal Misoprostol in Enhancing Cervical Ripening and Labor Induction

Abstract

Abstract Background Induction of labor is one of the most common procedures performed in the world of Obstetrics. Traditionally, labor induction is performed using prostaglandin and oxytocin. However, usage of corticosteroids nowadays is gaining a lot of interest regarding its effects on cervical ripening and shortening the physiological process of labor. Aim of work to evaluate the efficacy of intravenous dexamethasone versus vaginal misoprostol in enhancing cervical ripening and labor induction. Patients and Methods A randomized controlled clinical trial was carried out at Ain Shams University Maternity Hospital on (60) full term pregnant women between 39 – 42 weeks undergoing induction of labor, during a period from April 01, 2019 to November 30, 2019. Pregnant women were divided into two groups; vaginal misoprostol (control) group and intravenous dexamethasone (experimental) group (30 cases each). Results Our study showed that the mean time interval (hours) from initiation of labor induction to initiation of active phase was statistically significantly shorter among the dexamethasone (experimental) group 7.36 ± 2.23 versus 12.20 ± 4.92 hours among the vaginal misoprostol (control) group (p value < 0.001). Also, the mean time interval of the total duration between the induction of labor to successful vaginal delivery was statistically significantly shorter among the dexamethasone group 10.90 ± 4.17 versus 19.20 ± 5.62 hours among the vaginal misoprostol group (p value < 0.001). The results of this study showed the rate of initiation of active phase and rate of successful vaginal delivery were more in the experimental dexamethasone group than the control vaginal misoprostol control group. Conclusion Intravenous injection of 8 mg of dexamethasone before induction of labor is found to shorten the duration of labor induction by reducing the time interval between the initiation of labor induction and onset of active phase and the total duration from initiation of labor induction to delivery with no marked maternal or fetal complications. Recommendations Intravenous Dexamethasone can help cervical ripening and accelerate induction of labor. Further research should be taken in consideration with more population for more global evaluation.