ABSTRACT
To compare the efficacy of sublingual with oral misoprostol for induction of labour in primigravida with pre- labour rupture of membranes at term. Randomized controlled trial. Department of Obstetrics and Gynaecology Unit-11, Sir Ganga Ram Hospital, Lahore, from June 2004 to January 2006. The study included 100 primigravidas with singleton pregnancy at term, having pre-labour rupture of membranes and unfavourable Bishop score with no contraindication of induction of labour, vaginal delivery or misoprostol use. The cases were randomized into two equal groups, A and B. Women in the group A were given 100 micro g of misoprostol orally at an interval of 4 hours to a maximum of 2 doses while patients in the group B were prescribed the medicine sublingually [50 micro g, 4 hourly, maximum of 2 doses]. Induction to delivery interval, mode of delivery and fetomaternal complications were main outcome measures of the study. In the sublingual misoprostol group [B], 92% women delivered within 12 hours of induction while 84% of subjects delivered in this time period in oral group [A, p < 0.05]. There was no failed induction in either group. Regarding dosage, 64% of women delivered with single dose in group B while only 32% delivered with single dose in group A [p < 0.05]. The frequency of vaginal delivery was 92% in group B versus 80% in group A, while rate of caesarean section was 8% in the group B and 20% in the group A, which is statistically insignificant. No significant fetomaternal complications were seen in both groups. The efficacy of sublingual misoprostol in the dosage of 50 micro g was comparable to 100 micro g oral dose for the induction of labour in the primigravidas at term with pre-labour rupture of membranes