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Objective: To compare the efficacy and safety of misoprostol by sublingual and vaginal route for induction of labor in term viable pregnancies. Material and Methods: This prospective study was conducted on 200 women, who presented with indication of induction of labor. After taking informed consent cases were randomly divided into sublingual and vaginal group with 100 cases in each. Starting dose of misoprostol for induction in primigravida was 50μg and in miultigravida was 25μg followed by 25μg if required, up to maximum of 5 doses. Primary outcome was to determine efficacy of drug in term of total vaginal deliveries after induction and to determine safety in view of total number of cesarean section and fetal outcome. Secondary outcome was to compare total dose, number of doses, induction delivery interval, antepartum complications and fetal outcome in both groups. Result: Total number of successful vaginal deliveries were more in sublingual group (87%). Significant number of primigravidae in sublingual group delivered with single dose of 50μg misoprostol compare with vaginal group (56.89% in s/l v/s 32.69%in p/v group). Induction delivery interval, oxytocin augmentation, meconium stained liquor, abnormal uterine action, total number of cesarean sections all were less in sublingual group than vaginal group. No significant difference was seen in neonatal outcome. Conclusion: Sublingual route of misoprostol has better efficacy than vaginal route of misoprostol for induction of labor.

To compare the efficacy and safety of sublingual and vaginal dose of Misoprostol for induction of labor in term viable pregnancies