Comparative Study of Vaginal Misoprostol and Intracervical Dinoprostone Gel for Induction of Labour.

ABSTRACT

Induction of labour is an intervention to artificially stimulate uterine contractions leading to progressive dilation and effacement of cervix. This results in delivery of foetus before the onset of spontaneous labour. Dinoprostone gel and Misoprostol are commonly used drugs for cervical ripening. We wanted to compare the efficacy and safety of Dinoprostone with Misoprostol for cervical ripening and induction of labour in women with unfavourable cervix. METHODSThis is a prospective study conducted among 200 antenatal women who required induction of labour for different indications. 100 patients with an indication for induction were given 25 mcg of intravaginal misoprostol and repeat dose up to a maximum of 3 doses every 4 hours as needed. The other 100 patients were given 0.5 mg of intracervical dinoprostone gel and repeated for a maximum of 3 doses every 6 hours as needed. Progress of labour was monitored. Bishop score was determined. RESULTSPostdatism was the most common cause of induction (45% and 58%) in both the groups. The difference in values of mean induction delivery time in both primipara and multipara was not significant statistically for both the drugs. Study showed that the number of caesarean sections was significantly (p value 0.028) reduced with the use of misoprostol for induction of labour. The most common indication for operative delivery was foetal distress (11% in the misoprostol group and 17% in the dinoprostone group). Maternal and foetal complication rate in both the groups was similar. CONCLUSIONSCaesarean rate was significantly less with intravaginal misoprostol group compared to dinoprostone group. Other factors had no statistical significance. Vaginal misoprostol is thus a better option for induction of labour.