Abstract :
Background: Misoprostol is a synthetic PGE1 used for cervical ripening and induction of labour. However, the optimal dose of misoprostol to be used is a controversial issue.
Objective: of the study was to determine the efficacy and safety of 25 mcg versus 50 mcg vaginal misoprostol for induction of labour at term based on maternal and fetal outcomes.
Materials and Methods: This prospective cross-sectional study was carried out in the Department of Obstetrics and gynecology, Prathima Institue of Medical Sciences, Naganoor, Karimnagar. The patients were randomly allotted to either receive misoprostol 25 mg (Group I) or misoprostol 50 mg (Group II) respectively. The patient’s group was recorded in the case file. After the confirmation of Bishop’s score to be less than 6 the choosen dose of misoprostol was kept in the posterior fornix under aseptic conditions.
The doses were repeated after 6 hours with a maximum of 4 doses till the patients get adequate uterine contractions which are defined as three contractions per 10 minutes or cervical dilatation of > 3cms.
Results: Group I received 25mg of misoprostol intravaginally and Group II received 50mg of intravaginal misoprostol. The majority of women in this study n = 85 out of n=120 were primigravida. The distribution of primigravida in group I was n=48 and group II was n=37. The maternal complications were recorded in n=2(3.33%) of group II and n=1(1.67%) of group I patients. It appears that the higher doses of misoprostol used in group II is one of the cause although the values were statistically insignificant.
Conclusion: In conclusion, we found that the efficacy of 25mg of intravaginal misoprostol is comparable to 50 mg of intravaginal misoprostol for induction of labour. The advantages of 50mg of intravaginal misoprostol were it expedited vaginal deliveries. However, it also resulted in greater frequencies of complications to mother and fetus. Therefore we recommend the use of 25mg routinely and 50mg intravaginal misoprostol may be reserved for those with lower Bishop’s scores.
Keyword :
Misoprostol, Induction of labour.