Sublingual compared with oral misoprostol in term labour induction: a randomised controlled trial.
OBJECTIVE
To compare the efficacy and patient acceptability of 50 microg of sublingual misoprostol with 100 microg of oral misoprostol in the induction of labour at term.


METHODS
Non-blinded randomised comparative trial.


METHODS
Tertiary level UK Hospital.


METHODS
Two hundred and fifty women at term with indications for labour induction.


METHODS
Fifty micrograms of sublingual misoprostol or 100 microg of oral misoprostol was administered every four hours after random allocation, to a maximum of five doses.


METHODS
Number of patients delivering vaginally within 24 hours of the induction, mode of delivery, neonatal outcomes and patient acceptability.


RESULTS
There was no significant difference in the number of women delivering vaginally within 24 hours of the induction in the sublingual group as compared with the oral group (62.8% vs 59%, RR 1.1, 95% CI 0.6-2.1), or in the mean induction to delivery time (21.8 vs 24.1 h, mean difference 2.3 h 95% CI -2.2 to +6.7). There was no difference in the uterine hyperstimulation rates (1.6% in both groups), operative delivery rates or neonatal outcomes. In the sublingual group, 92.6% found the induction acceptable with 15.8% finding the tablets with an unpleasant taste, while in the oral group it was 96.9% and 4%, respectively. More patients in the oral group thought that they would consider the same method of induction again as compared with the sublingual group (58.6% vs 40%, RR 1.4, 95% CI 1.04-1.9).


CONCLUSIONS
Fifty micrograms of sublingual misoprostol every four hours has the same efficacy and safety profile as compared with 100 microg orally, but the oral route might be preferred by women.
Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, Foresterhill, UK.
Ashalatha
A
Shetty
Lisa
L
Mackie
Peter
P
Danielian
Pat
P
Rice
Allan
A
Templeton
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000284:Administration, Oral; D000286:Administration, Sublingual; D000328:Adult; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D007902:Length of Stay; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage; D017060:Patient Satisfaction; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors
D000020:Abortifacient Agents, Nonsteroidal; D010120:Oxytocics; D016595:Misoprostol