Randomized control trial of low dose oral misoprostol compared with intracervical dinoprostone gel for cervical ripening

2017 ◽  
Vol 7 (1) ◽  
pp. 104
Author(s):  
Savithri D. R. ◽  
Prashanthi Chennupalli ◽  
Suvarna R. ◽  
Akshatha S.
Keyword(s):  
Low Dose ◽  
Therapeutic Option ◽  
Caesarean Section Rate ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
P Value ◽  
Maternal Complications ◽  
Oral Misoprostol ◽  
Misoprostol Group ◽  
Dose Oral

Background: Induction of labour is a therapeutic option when the benefits of delivery outweigh risks of continuing pregnancy. There are several agents for induction of labour to achieve better outcome of labour. Acceptable methods for induction are oxytocin infusion, dinoprostone gel, misoprostol and mechanical cervical dilators. Prostaglandins are the preferred choice in unripened cervix. Objective of this study was to compare efficacy, safety of low dose oral misoprostol compared with intracervical dinoprostone gel for cervical ripening.Methods: One hundred women with single live fetus, term gestation, cephalic presentation, reactive fetal heart pattern and Bishops score <6 were included in the study. They were randomized to receive either 6 doses of 25ug oral misoprostol every 3rd hourly or 0.5ug intracervical dinoprostone every 6th hourly for a maximum of 3 doses.Results: Bishops score improvement after 6,12,18 hours in both the groups was statistically insignificant. Induction delivery interval was11.96±5.88 for misoprostol and 10.95±4.58 in dinoprostone group with P value 0.341 which was statistically insignificant. Need for oxytocin augmentation was less (18%) in misoprostol group as compared to dinoprostone group (44%). Caesarean section rate was slightly higher in misoprostol group (26% vs 24%). Meconium stained amniotic fluid was high in misoprostol group (16%) compared to dinoprostone group (8%). Maternal complications were minimal and neonatal outcome was good in both the groups.Conclusions: Compared to dinoprostone; misoprostol is easy to store, cost effective, stable at room temperature, can be easily administered and had better patient compliance and acceptability. It was found to be a better cervical ripening agent with similar maternal and fetal safety profile.

scholarly journals Neonatal outcome in randomized controlled trial of low dose oral misoprostol in comparison with intracervical Dinoprostone gel for labour induction

2017 ◽  
Vol 7 (1) ◽  
pp. 165
Author(s):  
Savithri D. R. ◽  
Suvarna R. ◽  
Prashanthi Chennupalli ◽  
Akshatha S.
Keyword(s):  
Low Dose ◽  
Neonatal Outcome ◽  
Therapeutic Option ◽  
Controlled Trial ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Oral Misoprostol ◽  
Misoprostol Group ◽  
Dose Oral ◽  
Meconium Staining

Background: Induction of labour is a therapeutic option when the benefits of delivery outweigh risks of continuing pregnancy. There are several agents for induction of labour to achieve better outcome of labour. Acceptable methods for induction are oxytocin infusion, dinoprostone gel, misoprostol and mechanical cervical dilators. Prostaglandins are the preferred choice in unripened cervix. To study the neonatal outcome in induction of labour with low dose oral misoprostol compared with intracervical dinoprostone gel and also to assess occurrence of meconium staining liquor.Methods: One hundred women with single live fetus, term gestation, cephalic presentation, reactive fetal heart pattern and Bishops score <6 were included in the study. They were randomized to receive either 6 doses of 25ug oral misoprostol every 3rd hourly or 0.5ug intracervical dinoprostone every 6th hourly for a maximum of 3 doses. Oxytocin was administered. Fetal outcome was assessed in terms of APGAR score, meconium staining and need for NICU.Results: Meconium stained amniotic fluid was high in misoprostol group (16%) compared to dinoprostone group (8%). NICU admissions were seen in 7 neonates in both groups.Conclusions: Low dose oral misoprostol is a safe method of labour induction. APGAR and NICU admission rates were comparable in both groups. Meconium staining was more in misoprostol group compared to dinoprostone group.

scholarly journals Comparative study of oral PGE 1 and intracervical PGE2 gel for pre-induction cervical ripening in prelabour rupture of membranes >37 weeks gestational age

2018 ◽  
Vol 7 (5) ◽  
pp. 1801
Author(s):  
Alka N. Nadar ◽  
Sirisha P. S. R. N. S.
Keyword(s):  
Gestational Age ◽  
Low Dose ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Time Duration ◽  
Oral Misoprostol ◽  
Misoprostol Group ◽  
Successful Induction ◽  
To Receive ◽  
Mean Time

Background: Active induction of labour in prelabour rupture of membranes resulted in a lower risk of maternal and fetal sepsis as compared to conservative management. Pre-induction cervical ripening helps in successful induction of labour.in this study we have compared the efficacy of low dose 25 mcg oral misoprostol versus intracervical PGE2 gel for cervical ripening in term PROM patients.Methods: Women with pregnancies between 37 and 41 weeks gestational age presenting with PROM at term and a Bishop score of 4 or less were randomly assigned to receive either a 25-mcg oral misoprostol every 4-hourly interval or 3 applications of intracervical PGE2 gel at a 6-hour interval for effective cervical ripening. Oxytocin was initiated if labor had not started after 6 hours of last effective dose of prostaglandin.Results: Fifty-three women (75.73%) (n = 70) in the oral misoprostol group with 2 doses, 4 hours apart had successful cervical ripening within 8 hours in comparison to sixty-two women (88.58%) (n = 70) in the intracervical PGE2 gel group with 2 doses, 6 hrs apart approximately 12 hrs for successful ripening. (p = 0.021). Oral misoprostol group needed shorter mean duration interval for the Bishop score <4 to >6 than intracervical PGE2 gel group, 7.84±3.64 hours and 9.39±4.20 hours respectively (p = 0.022). Similarly, the mean time duration interval from ruptured membranes to vaginal delivery in oral misoprostol was shorter i.e. 12.60±3.78 hours versus 14.66±4.08 hours (p = 0.005).Conclusions: Low dose 25 mcg oral misoprostol is a safe, efficacious and better tolerated alternative to intracervical PGE2 gel for pre-induction cervical ripening in especially in PROM patients at term.

Low-dose oral misoprostol for induction of labour

2021 ◽  
Vol 2021 (6) ◽  
Author(s):  
Robbie S Kerr ◽  
Nimisha Kumar ◽  
Myfanwy J Williams ◽  
Anna Cuthbert ◽  
Nasreen Aflaifel ◽  
...  
Keyword(s):  
Low Dose ◽  
Induction Of Labour ◽  
Oral Misoprostol ◽  
Dose Oral

scholarly journals Comparative study of intravaginal misoprostol versus dinoprostone gel for induction of labour in primigravida

2021 ◽  
Vol 10 (11) ◽  
pp. 4194
Author(s):  
Shirish S. Dulewad ◽  
Chitikala Haritha
Keyword(s):  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Vital Signs ◽  
Cost Effective ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Controlled Study ◽  
Tertiary Care Centre ◽  
Misoprostol Group ◽  
Fetal Wellbeing

Background: Labour is an inevitable consequence of pregnancy. The aim of the present research was to study the safety, efficacy and effect of intravaginal misoprostol and dinoprostone gel for induction of labour.Methods: 300 patients who required induction of labour in a tertiary care centre were included in this prospective randomized controlled study from August 2019 to August 2021 with a study duration of 12 months. 50% of cases received 25 µg of intravaginal misoprostol and repeated for a maximum of 6 doses every 4 hours as needed. 50% cases received 0.5 mg dinoprostone gel and repeated for maximum of 2 doses every 6 hours as needed. The patients selected were evaluated initially by modified Bishop’s score and admission test for fetal wellbeing. After drug insertion, patients were monitored for fetal heart rate, vital signs, progress of labour. A partogram was strictly maintained in all patients.Results: The highest number in both groups being below 40 weeks which were 74% and 76% in dinoprostone and misoprostol groups respectively. Rest were between 40.1-41.6 weeks. The mean induction delivery interval in dinoprostone was more (16.15±3.1) than in misoprostol (12.26±2.21). Requirement of oxytocin augmentation was less in misoprostol group than dinoprostone group. Caesarean section rate was less in misoprostol group. Maternal side effects were minimal in either groups and neonatal outcome was good in both the groups.Conclusions: Both misoprostol and dinoprostone gel are safe, effective for cervical ripening and induction but misoprostol is more cost effective and stable at room temperature. 

scholarly journals TO COMPARE THE EFFICACY OF PGE2 GEL AND 25ΜG OF INTRAVAGINAL MISOPROSTOL FOR INDUCTION OF LABOR IN TERM PROM

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Sunita Maheshwari ◽  
Shweta Jinger
Keyword(s):  
Low Dose ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Term Pregnancy ◽  
Vaginal Tablet ◽  
Misoprostol Group ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Group B

Background: Induction of labour is one of the most common obstetric interventions worldwide. The study was conducted to compare the efficacy and safety of 25µg (low dose) vaginal Misoprostol with intracervical Dinoprostone for cervical ripening and induction of labour in term pregnancy. Methods: For the purpose of this study, 100 term pregnancy patients (only primigravidae and second gravidae) were included who had spontaneous rupture of membrane before onset of labor. Data was collected from cases admitted in labor room at Pannadhay Mahila Chikitsalaya associated with RNT Medical College,Udaipur between July 2014 to July 2015. Results: Requirement of Oxytocin for augmentation of labor between group A and group B. It is evident from the table that oxytocin was required in only 16% of patients in group A, while 46% in group B. This indicates that requirement of oxytocin was significantly less in misoprostol group (P<0.001). Conclusion: This study was designed to assess efficacy of a 25 μg misoprostol vaginal tablet, Finding confirms that vaginal misoprostol tablet is as effective as dinoprostone in cervical ripening and labour induction with dinoprostone. Keywords: Cervical ripening, Dinoprostone, Labour induction, Low- dose misoprostol.

scholarly journals Oral misoprostol solution in comparison to vaginal misoprostol for induction of labour in a randomized controlled trial

2020 ◽  
Vol 9 (9) ◽  
pp. 3530
Author(s):  
Ahmed M. Abbas ◽  
Peter R. Thabet ◽  
Amgad E. Abour Gamrah ◽  
Osama S. El-Kady
Keyword(s):  
Controlled Trial ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Controlled Clinical Trial ◽  
P Value ◽  
Randomized Controlled ◽  
Group I ◽  
Oral Misoprostol ◽  
Vaginal Misoprostol

Background: With more than 15% of all gravid women requiring prostaglandins in cervical ripening and labour induction. However, evidence is not clear about the preferred route or dose of the drug. So, this study was designed with objectives to compare the induction delivery interval and safety of titrated oral misoprostol solution with vaginal misoprostol for labour induction in term primigravida women.Methods: This randomized controlled clinical trial was conducted on a total of 100 patients randomly selected among primigravida at term women undergoing induction of labour for obstetric or medical indication for labour induction in Ain Shams University Maternity Hospital. They were divided into two Groups: Group I: patients undergoing induction of labour using misoprostol oral solution and Group II: patients undergoing induction of labour using vaginal misoprostol.Results: Oral misoprostol solution has less induction delivery duration and less side effects than vaginal misoprostol. The induction-delivery time with the oral route compared to the vaginal one (15.2 versus 20.3 hours respectively) with significant p-value (<0.001).Conclusions: Titrated oral misoprostol is safe and effective for labour induction in primigravida patients with unfavorable cervix.

scholarly journals A comparative study of low dose vaginal misoprostol and dinoprostone gel for induction of labour at term of pregnancy

2016 ◽  
Vol 6 (1) ◽  
pp. 207
Author(s):  
. Kalpana ◽  
Priya Sharma ◽  
Amit Kaushik ◽  
Priyanka Rao ◽  
Neelam Swaroop ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Low Dose ◽  
Mode Of Delivery ◽  
Induction Of Labour ◽  
P Value ◽  
Induction Agent ◽  
Early Labour ◽  
Misoprostol Group ◽  
The Mean ◽  
Vaginal Misoprostol

Background: The aim of this study was to compare the low dose of vaginal misoprostol and dinoprostone gel for the induction of labour at term of pregnancy.Methods: The study was conducted on 90 women, randomized into two groups, each group having 45 women. First group received misoprostol per vaginally and second group received the dinoprostone gel. The duration of induction to delivery interval, mode of delivery and complications related to labour or foetus were recorded.Results: The mean induction to delivery interval in the misoprostol group was 11.68 ± 4.49 hours and in the dioprostone gel group was 14.85 ± 7.08 hours. Applying the modified t-test, this difference is statistically significant (P value 0.004). Thus misoprostol leads to early labour and early delivery as compared to dinoprostone gel.Conclusions: As shown in this study, vaginal misoprostol is highly effective induction agent with no adverse effect on the outcome of labour as compared to dinoprostone gel.

scholarly journals A study of effect of oral PGE1 and cervical PGE2 on induction of labor and mode of delivery

2018 ◽  
Vol 7 (6) ◽  
pp. 2160
Author(s):  
Sukanya Mukherjee ◽  
H. Valson ◽  
Balaji K.
Keyword(s):  
Mode Of Delivery ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
P Value ◽  
Singleton Pregnancy ◽  
Outcome Indicators ◽  
Oral Misoprostol ◽  
Vaginal Deliveries ◽  
Group A ◽  
Group B

Background: Induction of labor is one of the most important procedures done by the Obstetricians. Induction of labor with the help of prostaglandins offer the advantage of promoting cervical ripening along with stimulating the contractility of the myometrium.Methods: 200 pregnant women with singleton pregnancy both nulliparous and multiparous, were included in the study at term gestation (>39weeks) with Bishop’s score <6, and reactive NST. The subjects were divided in to two groups Group A including patients who were given oral PGE1 - 50 mcg Tab, and Group B with cervical PGE2, 0.5 mg, gel. The outcome indicators were recorded in both Group A and Group B and analyzed. The mean time taken from induction to vaginal delivery in Group A was 628±67 minutes and in Group B was 839±118 minutes. Incidence of LSCS in Group B when compared to Group A (p value <0.005).Results: Incidence of LSCS in Primi’s in Group B compared to Primi’s in Group A was statistically significant (p value 0.009). Non-progression of labor was observed to be the major indication for LSCS in Group B. Meconium stained labor was found to be the major indication for LSCS in Group A.Conclusions: The study concludes that using 50 mcg oral misoprostol, is an effective and safe mode of induction of labor in comparison to PGE2 gel. Vaginal deliveries are more with the use of oral misoprostol and the induction to delivery interval is also lesser than that in cervical PGE2 use.

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