Efficacy of dinoprostone, intracervical foleys and misoprostol in labor induction.
OBJECTIVE
To compare the efficacy for Dinoprostone, intracervical foleys and misoprostol in labor trial regarding effects on cervical ripening, mode of delivery, induction to delivery interval and maternal complications i.e. tachysystole and postpartum haemorrhage.


METHODS
Randomized clinical trial.


METHODS
Hamdard University Hospital and Patel Hospital between July 2004-June 2005.


METHODS
Randomized trial was conducted such that group-A received Dinoprostone at 6 hourly intervals upto two doses. Group-B was induced with intracervical foley catheter. Group-C received 50 micro g oral misoprostol 4 hourly to a maximum of four doses. Cervical ripening, induction to delivery time interval, mode of delivery and maternal morbidity were main outcome measures. Test of proportions was used to compare the significance between the managements.


RESULTS
In 226 cases, 219 (97%) were successfully induced while 7(3%) did not respond the labour induction. The rates of caesarean section in dinoprostone, intracervical foley and misoprostol were 14.7%, 14.1% and 12.3%, respectively, however, this difference was insignificant among three groups (p=0.911). Rate of earlier response (< or = 12 hours) to labor induction among three groups was insignificant (3.8% vs 4% and 13.7% respectively, p=0.125). Marginal significance of higher rate of complications was observed in those patients who were given misoprostol (p=0.08).


CONCLUSIONS
In this series, all three agents were equally effective in terms of cervical ripening, induction-delivery interval, mode of delivery and maternal complications.
Saleem
Samina
S
Department of Obstetrics and Gynaecology, Hamdard University Hospital, Taj Medical Complex, M.A. Jinnah Road, Karachi. alidojki@hotmail.com
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002404:Catheterization / Q000379:methods*; D020070:Cervical Ripening / Q000187:drug effects; D002585:Cesarean Section; D016009:Chi-Square Distribution; D015232:Dinoprostone / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000009:adverse effects / Q000379:methods*; D008423:Maternal Age; D016595:Misoprostol / Q000627:therapeutic use*; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011336:Probability; D018570:Risk Assessment; D016896:Treatment Outcome
D016595:Misoprostol; D015232:Dinoprostone