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Six hourly vaginal misoprostol versus intracervical dinoprostone for cervical ripening and labor induction
Author(s) -
Agarwal Nutan,
Gupta Anjali,
Kriplani Alka,
Bhatla Neerja
Publication year - 2003
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1046/j.1341-8076.2003.00091.x
Subject(s) - misoprostol , dinoprostone , medicine , labor induction , oxytocin , bishop score , obstetrics , meconium , vaginal delivery , gynecology , anesthesia , pregnancy , abortion , cervix , fetus , prostaglandin e2 , genetics , cancer , biology
Aim: Prospective clinical trials were conducted to assess the safety and efficacy of 6‐hourly vaginal misoprostol versus intracervical dinoprostone for induction of labor. Methods: A total of 120 pregnant women requiring induction of labor were recruited. Cases were randomized to receive either 50 µg vaginal misoprostol 6 hourly (group I, n = 60) or 0.5 mg intracervical dinoprostone 6 hourly (group II, n = 60). Outcome measures, such as change in Bishop's score, need of oxytocin, induction delivery interval; complications like tachysystoly, hyperstimulation, abnormal fetal heart rate, and meconium passage were compared between two groups. Statistical analysis was performed by Wilcoxan's Rank sum and Student's t ‐test. Results: Bishop score rise, after 6 h of initiation of therapy was significantly higher in the misoprostol group than dinoprostone, 2.98 ± 2.57 versus 2.05 ± 1.83 ( P = 0.04). The need of oxytocin augmentation was reduced in misoprostol versus dinoprostone group, 16.6% versus 78.3% ( P = <0.001). Induction delivery interval was shorter in misoprostol; 12.8 ± 6.4 h versus 18.53 ± 8.5 h in dinoprostone group ( P = <0.01). One case (1.6%) in misoprostol group, but none in dinoprostone had tachystole ( P = 1.00). Abnormal heart rate pattern was found more in misoprostol than dinoprostone 16.6% versus 4.9% ( P = 0.14) and so was the incidence of cesarean section, 26.6 versus 15%, respectively ( P = 0.47). Meconium passage was the same in both groups, 10% in each group. Conclusion: Vaginal misoprostol 50 µg 6‐hourly is safe and effective for induction of labor with lesser need of oxytocin augmentation and shorter induction delivery interval.