Is expensive always better? Comparison of two induction agents for term rupture of membranes.
The aim of this study was to compare the clinical safety and efficacy of sublingual misoprostol with vaginal prostaglandin E2 (Prostin(R)) as an induction agent after term rupture of membranes. This was a non-blinded randomised control study involving 57 women who were >24-48 h after term rupture of membranes. In total, 29 women received sublingual misoprostol and 28 received Prostin. The mean induction of labour to delivery time was 20.71+/-11.59 h in the Prostin group and 13.96+/-9.90 h in the misoprostol group, (p = 0.021). Some 46.4 % (13/28) of the Prostin group needed a second dose compared with only 20.7 % (6/29) of the misoprostol group (p = 0.039). Oxytocin infusion was used by 57% (16/28) of the Prostin group compared with 31% (9/29) of those who had received misoprostol, (p = 0.047). In our study, sublingual misoprostol when compared with vaginal prostaglandin E2 gel (Prostin) leads to a shorter induction to labour time, and less need for second dose of induction agent or oxytocin infusion. Women were given a satisfaction questionnaire to complete after delivery. Those who were given misoprostol were satisfied with the outcome, would use it again in the future, and recommend it to friends in similar circumstances.
Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK.mparisaei@hotmail.com
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Parisaei
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Erskine
D000282:Administration, Intravaginal; D000286:Administration, Sublingual; D000328:Adult; D017046:Cost Savings; D015232:Dinoprostone / Q000008:administration & dosage* / Q000191:economics; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005321:Extraembryonic Membranes / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007751:Labor, Induced / Q000191:economics / Q000379:methods*; D008131:London; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage* / Q000191:economics; D017060:Patient Satisfaction; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012016:Reference Values; D018570:Risk Assessment; D016037:Single-Blind Method; D047929:Term Birth
D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone