Volume : 7, Issue : 8, August - 2018

Comparative study of oral misoprostol and vaginal misoprostol in the induction of labour

Pandurangaiah R, Leela Gr, Asokan Keloth Manapatt

Abstract :

<p>&nbsp;Introduction: Misoprostol has been in use for cervical priming since 1979 [1]. Even though there are many</p> <div>methods of induction of labour, misoprostol is the commonest medical agent used for induction of labour [2]. A</div> <div>comparative study of oral misoprostol and vaginal misoprostol was conducted at Kannur Medical College during a period of two years from</div> <div>2016 to 2018, in the effectiveness of induction of labor</div> <div>Objectives:</div> <div>1. To compare the efficacy of misoprostol and oxytocin in the induction of labor</div> <div>2. To compare the complications of oral misoprostol and vaginal misoprostol</div> <div>3. To compare the induction-to-active phase of labor time</div> <div>4. To compare the induction-to-delivery time</div> <div>5. To compare the need for oxytocin augmentation</div> <div>6. To compare the failure rate</div> <div>Methods: A total number of cases selected for study purpose were 150 for a period of about 2 years from 22 November 2016 to 28 July 2018.</div> <div>Induction was done for various indications. Oral misoprostol group received 50 &mu;g every four hours and vaginal insertion group received a</div> <div>25 &mu;g for every four hours. The duration between onset of induction and delivery was recorded in both groups. The onset of active phase of</div> <div>labour was also noted. Maternal and fetal complications also were noted separately. Labour was monitored by partogram and cesarean</div> <div>delivery were conducted in case of dysfunctional labour. Such cases were counted as failure of induction</div> <div>Result : Failure of induction by misoprostol was less with oral misoprostol, 17.9% comparing to vaginal insertion which was 24.6%, with</div> <div>statistical signi􀃶cance (P &lt; 0.001). Induction-to-delivery time was shorter for oral misoprostol group (P &lt; 0.001). Induction-to-active labor</div> <div>was also shorter for oral misoprostol group (P &lt; 0.001). Use of oxytocin augmentation in oral group was less in oral misoprostol group (p</div> <div>&lt;0.001). Complications, maternal, and fetal were similar in both groups (p 0.1) except uterine hyperstimulation which was more in vaginal</div> <div>group (p &lt;0.01). Failure rate was also less in oral misoprostol group. (p &lt;0.001)</div> <div>Conclusion: Oral misoprostol is a safe and effective method of induction of labor which is far superior to vaginal insertion of misoprostol.</div>