ABSTRACT
This clinical trial was to evaluate and to compare the effectiveness, safety, and side effects of intravaginal misoprostol [prostaglandin E1] with vaginal dinoprostone for cervical ripening and labor induction in Bab El-Shaariah Hospital. Women with Biopsy score 6 or less admitted for labor induction at term were eligible for this randomized controlled trial. Exclusion criteria were multiple pregnancy, breech, fetal distress, or previous uterine scar. The allocation to the intravaginal micoprostol group [145 patients] [20 micro g given every 2 hours increased to 40 micro g depending on uterine contractions] or to the vaginal dinoprostone group [81 patients] [2mg twice, 6 hours apart] from March 2004 to February 2006. The mean time to delivery was significantly shorter with misoprostol [19.8 +/- 10.4 hours] than with prostaglandin E2 [31.3 +/- 13.0 hours, p<0.001]. Delivery within 24 hours of induction was significantly more frequent with misoprostol [71.9% of subjects vs 31.3%, p<0.001]. There was no difference in the cesarean delivery rate with misoprostol [25.6% Vs 22.2%, p<0.67]. The incidence of uterine hyper-stimulation was higher with prostaglandin E2 [7.4% Vs 0.7%, p<0.007]. There were no uterine ruptures with both groups. There was no difference in neonatal outcome. Compared with prostaglandin E2, misoprostol is more effective in cervical ripening and induction of labor, is as safe for patients who do not have a history of cesarean birth