Abstract

Objective:  To compare the efficacy and safety of intravaginal misoprostol 50µg and PGE2 3mg for induction of labor.
Study Design: Birth register based cohort study
Settings: Maternal and Child Health Centre, PIMS, from January 1 to June 30, 2010.
Methodology:  A total of 249 women between 36 to 43 weeks gestation, undergoing induction of labour (IOL) with misoprostol or PGE2 at bishop’s score ≤ 6 were included. Primary outcome measures were induction to delivery interval, mode of delivery, and neonatal admission in SCBU. Secondary outcome measures were number of doses required, postpartum haemorrhage and tachysystole. Chi square and t test were used to determine the significance of difference between two groups.
Results: Out of 249 women, 142 (57%) were primigravidae and 107 (43%) multigravidae. There was no significant difference in baseline characteristics between two groups. Misoprostol was used in 162 (65%) while, PGE2 in 87(35%) women, repeated every 6 hours, for a maximum of three doses. There were no significant differences in the mean induction to delivery interval, doses required (p=0.39), percentage of women achieving vaginal delivery within twelve hours (p= 0.45), frequency of caesarean delivery ( p=0.52) or complications as tachysystole, and PPH (p=0.7). PGE1 group had higher but statistically insignificant caesarean section rate due to failed induction (p=0.06). A higher proportion of babies in the misoprostol group needed admission in SCBU (p=0.03).
Conclusion: Vaginal misoprostol is cheaper than and as effective as PGE2 for induction of labour at term, but is associated with more SCBU admissions.
Key Words: Misoprostol , Prostaglandin E2, Vaginal pessary, Oxytocics, Induced Labor, Neonatal outcome.