Sublingual versus oral misoprostol for induction of labour in prelabour rupture of membranes at term

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