Induction of labour at term: 25 mcg 2 hourly oral misoprostol or 6 hourly intracervical cerviprime, safety and efficacy

Background: There are various methods for induction of labour, both mechanical and pharmacological. Prostaglandins in induction have been commonly used. Studies have been done using vaginal and sublingual use of misoprostol. This study analyses efficacy of both oral misoprostol used in low frequent doses as per FIGO 2017 guidelines and intracervical prostaglandins for induction of labour.Methods: A total 159 consecutive pregnant term mothers with singleton pregnancy, intact membranes and unfavorable cervix were subdivided into two subgroups, first subgroup was administered 25 mcg oral misoprostol at 2 hourly interval and those in subgroup B were given intracervical PGE2. Both these subgroups were prospectively followed to assess efficacy in induction of labour at term and outcome in foetus and mother. Statistical analysis was done using chi square test.Results: It was found that the induction to delivery interval was significantly lesser in the cerviprime group (19.31 hours) compared to the misoprostol group (25.19 hours). However, there was no significant difference in the rate of vaginal delivery and mean duration of labour, rates of caesarean section, maternal and neonatal complications in both the groups. More women in the cerviprime group required augmentation with oxytocin. However, on comparing the cost of induction as per the mean doses used, the cost of induction with misoprostol was much lesser than that of cerviprime use.Conclusions: Oral use of Tab. misoprostol was not more efficacious than the use of cerviprime gel in induction of labour.

Comparative study of prostaglandin E2 gel with oxytocin infusion for induction of labor.

Objectives - To compare the safety and efficacy of prostaglandin E2 gel with I.V. oxytocin for induction of labour. Methods - Over 200 pregnant women admitted for induction of labour were randomly allocated into two groups; Group A (100 women) who had pre induction cervical ripening with prostaglandin E2 gel; Group B(100 women) who received IV oxytocin without cervical ripening. Statistical analysis used: Student t test, Z test, correlation of coefficient. Results: The demographic characteristics of the women and indications of labor in both groups were comparable. The mean Bishop score at 12 hours in group A and group B were 9.33 ±1.63 and 5.76 ±3.07 respectively and were statistically significant (p<0.05). The mean duration of labor in group A was 8.99±4.7 hours and in group B was 16.22±5.11 hours. The difference was highly significant (p< 0.0005). The complications and side effects were minimal with good neonatal outcome in group A compared to group B. Conclusion: Prostaglandin E2 gel when used intracervically is a safe and effective method for induction of labour.