SAFETY AND EFFICACY OF SUBLINGUAL MISOPROSTOL AND INTRACERVICAL DINOPROSTONE GEL AS CERVICAL RIPENING AGENT IN TERM PRELABOUR RUPTURE OF MEMBRANES: A COMPARATIVE STUDY

Abstract

Introduction: "premature rupture of membranes" (PROM) refers to the chorioamnionitis membranes spontaneously rupturing before the start of labour. This study compares the safety and effectiveness of intracervical dinoprostone gel and sublingual misoprostol for cervical ripening in term PROM. Methods: This is an analytical cross-sectional study including 100 term mothers with spontaneous PROM attending obstetric casualty at the Department of Obstetrics and Gynaecology, Government Raja Mirasudhar Hospital, Thanjavur, India, selected using a multistage sampling technique from the study period of February 2021 – November 2021 (10 months). One hundred samples were assigned randomly into two groups which were 50 in each group as group A (Misoprostol group) and group B (Dinoprostone gel group). Results: In group A, the study participants' median ages were 25 years (8.48) and 26.2 years (6.42), respectively. The difference in age averages between groups A and B was found to be 6.03, with a statistically significant p-value of 0.016. In both groups, the induction delivery interval was nearly equal. The link between the Indication for Lower Segmental Caesarean Section and both groups was statistically significant. When the two groups' delivery modes were compared, natural labour was shown to be statistically significant (p = 0.048). Normal and abnormal heart rates were statistically significant for the association between fetal heart rate and the groups, respectively, with chi-square values of 6.854 and 9.281 (p = 0.022 and 0.013, respectively). The remaining groups were not statistically significant. Conclusion: It was concluded that though sublingual misoprostol is more efficacious than intracervical dinoprostone, its safety margin is significantly less; hence, misoprostol induction should be done only in a double setup under medical supervision.