European Journal of Biomedical and Pharmaceutical Sciences

COMPARISON OF OUTCOME OF ORAL VERSUS VAGINAL ADMINISTRATION OF MISOPROSTOL FOR INDUCTION OF LABOUR AT TERM

Fariha Tahir*, Qurat-Ul-Ain Nazir, Sana Danish

ABSTRACT

Introduction: Induction of labor before its spontaneous onset is often necessary in everyday practice. There is no single, clear best practice with respect to the choice of agent used for cervical ripening: both mechanical and pharmacologic agents are acceptable options, in general. The rationale of the study is that limited data is available comparing the outcome of misoprostol when used orally versus when used through vaginal route. The route with better induction of labor and easy to use will be recommended to other obstetricians. Objective: To compare the outcome of oral versus vaginal administration of misoprostol for induction of labour at term (gestational age >37 weeks). Study Setting: The study was conducted in Obstetrics & Gynecology Department, Shaikh Zayed Hospital, Lahore. Duration of Study: January 11, 2023 to July 10, 2023. Study Design: Randomized controlled trial. Subjects & Methods: Total 180(90 in each group) patients were enrolled. The women randomized to group-A received 50 microgram oral misoprostol 6 hourly orally up to a maximum of 4 doses. The women randomized to group B received 50 microgram misoprostol vaginally and repeated at 6 hours interval up to a maximum of 4 doses. Successful induction of labor was noted. Patient who successfully delivered the newborn vaginally were noted in each group. Data was entered and analyzed using SPSS v25.0. Post-stratification, Chi-square test was applied to see the effect on outcome taking p-value ≤0.05 as significant. Results: Age range in this study was from 18 to 40 years. The mean age of patients in group-A was 27.67±6.012 year and in group-B was 28.52±6.088 year. In group-A, mean gestational age was 38.28±4.37 weeks and 38.15±4.41 weeks in group-B. In group-A, mean number of doses was 2.7±1.3 and 2.3±1.2 in group-B. In Oral misoprostol group, 63(70.0%) had successful labour induction and 79(87.8%) had successful labour induction in Vaginal misoprostol group. In Oral misoprostol group, 62(68.9%) had vaginal delivery and 78(86.7%) had vaginal delivery in Vaginal misoprostol group with a p-value 0.004, which is statistically significant. Conclusion: There is difference in the outcome of oral versus vaginal administration of misoprostol in terms of successful induction of labour at term and vaginal delivery. Compared with vaginal misoprostol, oral misoprostol may be associated with increased risk of cesarean delivery and lesser labour induction.

Keywords: Induction of Labour, Cervical Ripening, Vaginal Misoprostol, Oral Misoprostol.