Induction of labor: a comparative study of intravaginal misoprostol and dinoprostone.

OBJECTIVE: To compare the efficacy and safety of intravaginal misoprostol and dinoprostone for elective induction of labor in nulliparous women with an unfavorable cervix. MATERIALS AND METHODS: A quasi-experimental study was conducted in Bahawal Victoria Hospital, Bahawalpur, Pakistan, from July 1, 2005 to August 31, 2006. A total of 120 primigravid women with gestational ages of > 40 weeks to < 42 weeks were divided into two groups. Group A (n = 60) was given 50 microg of misoprostol and Group B (n = 60) was given 3 mg of dinoprostone every 6 hours, for a maximum of three doses. RESULTS: The induction to onset of significant uterine contractions and delivery intervals were lower in Group A than in Group B (6.1 vs. 7.2 hours; p = 0.16; and 8.2 vs. 11.0 hours; p = 0.007, respectively). Group A had a lower cesarean section rate than Group B (7% vs. 30%; p = 0.003), but a higher rate of uterine hyperstimulation (10% vs. 3%; p = 0.16), tachysystole (17% vs. 3%; p = 0.02), and neonatal admissions to the intensive care unit within 24 hours of delivery (4 vs. 3; p = 0.71) and after 24 hours (2 vs. 1; p = 0.56) than Group B. CONCLUSION: Vaginal misoprostol is more effective than dinoprostone for the elective induction of labor beyond 40 weeks of gestation, but is associated with more uterine hyperstimulation, tachysystole, and neonatal intensive care unit admissions.

Labour induction with randomized comparison of oral and intravaginal misoprostol in post date multigravida women.

The efficacy and safety of oral versus vaginal misoprostol for elective induction of labor in post date multigravida with an unfavourable cervix was compared over a period of one year in the Bahawal Victoria Hospital, Bahawalpur, Pakistan. Eightyeight multigravida post date women were divided into two groups and given 50 mg misoprostol orally and 50 mg intravaginally, respectively. The induction to onset of significant uterine contractions and delivery intervals were lower in the first group (7.8 h vs. 8.9 h) when compared to (10.4 h vs. 12 h). The first group had a higher rate of Caesarean section (7% vs. 4%; p>0.05), uterine hyperstimulation (9% vs. 5%; p>0.05), uterine tachysystole (23% vs. 14%; p>0.05) and neonatal admissions to intensive care unit (12% vs. 4%; p>0.05) when compared to second group. Fifty mg oral misoprostol has the potential to induce labor as safely and effectively as the intravaginal route.