Comparison of the Efficacy and Safety of Misoprostol with That of Dinoprostone as a Cervical Ripening and Inducing Agent

ABSTRACT

Background: Induction of labour is defined as the stimulationof uterine contractions using medical or surgical means prior tospontaneous labor in order to achieve vaginal delivery.Dinoprostone gel has been widely used as cervical ripeningand inducing agent. There has been a growing interest in usingmisoprostol, a prostaglandin E1 analogue, as an alternativeagent for inducing labor. Hence; the present study wasconducted for comparing the efficacy and safety of misoprostolwith that of dinoprostone as a cervical ripening and inducingagent.Materials & Methods: A total of 60 eligible women whorequired induction of labour were admitted. After taking a wellinformed consent; detailed history, general examination andobstetric examination was conducted. Patients who fulfilled theabove criteria were divided in two groups either to receivemisoprostol tablet 25µg every 4 hourly intravaginally upto amaximum of 5 doses or dinoprostone gel 0.5mg intracervicallyevery 6 hourly upto a maximum of 3 doses. IntravenousOxytocin was administered as and when required in eithergroup. A Performa was filled for each patient and at the end ofstudy data collected from these Performa’s was tabulated in amaster chart. Statistical analysis was done using SPSSsoftware.Results: Initial Bishops score in the misoprostol anddinoprostone group was 3.85±1.26 and 3.89±0.97respectively. Change in the Bishops score after single dose ofmisoprostol and dinoprostone was 5.48±1.89 and 5.0±2.05respectively. This result was statistically not significant. 66.67%of patients in the dinoprostone group where as 60% of patientsin the misoprostol group required oxytocin. This difference wasnot statistically significant. Only 5 subjects required 3 doses ofdinoprostone whereas 14 subjects needed 2 doses and 11subjects needed only 1 dose of dinoprostone. There were 5cases of failure of induction in the dinoprostone group ascompared to only 3 cases in the misoprostol group. The resultwas not statistically significant.Conclusion: Both dinoprostone and misoprostol are equallysafe and efficacious in cervical ripening and labor induction.