title: A randomized clinical trial to compare the efficacy of different doses of intravaginal misoprostol with intracervical dinoprostone for cervical ripening and labor induction.
abstract: OBJECTIVE
  To compare the efficacy of 25 vs. 50 microg of intravaginal misoprostol vs. intracervical dinoprostone for cervical ripening and labor induction.
  
  
  METHODS
  210 women with Bishop's score <6 were randomized into 3 groups of 70 each to receive 6 hourly doses of either 25 or 50 microg of intravaginal misoprostol or 0.5 mg intracervical dinoprostone to maximum of 3 doses and outcome parameters were compared.
  
  
  RESULTS
  Induction to vaginal delivery interval was significantly lower (p < 0.05) for 50 microg (13.8 +/- 6.62 hours) as compared to 25 microg misoprostol (16.4 +/- 7.34 hours) or dinoprostone group (16.3 +/- 7.49 hours). Maximum improvement (p < 0.05) in Bishop's score and minimum oxytocin requirement (p < 0.05) was seen with misoprostol 50 microg. No significant difference was observed for women delivering vaginally within 24 hours (93.8 vs. 89.7 vs. 85.4%), patients delivering after one dose (24.3 vs. 21.4 vs. 20%), cesarean deliveries, fetal outcome, complications like hyperstimulation and fetal heart abnormalities for the 50 vs. 25 microg misoprostol vs. dinoprostone group.
  
  
  CONCLUSIONS
  Intravaginal misoprostol 50 microg administered 6 hourly appears to be most effective as it has least induction to delivery time, has maximum improvement in Bishop's score, least oxytocin requirement without any increase in complication rate.
authors.affiliation: Department of Obstetrics and Gynecology, Lady Hardinge Medical College and Shrimati Sucheta Kriplani Hospital, New Delhi, India. pikeesaxena@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: Saxena
authors.forename: M
authors.initials: M
authors.lastname: Puri
authors.forename: M
authors.initials: M
authors.lastname: Bajaj
authors.forename: A
authors.initials: A
authors.lastname: Mishra
authors.forename: S S
authors.initials: SS
authors.lastname: Trivedi
mesh_terms: D000282:Administration, Intravaginal; D020070:Cervical Ripening / Q000187:drug effects*; D002585:Cesarean Section; D015232:Dinoprostone / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007194:India; D007745:Labor Onset / Q000187:drug effects*; D007751:Labor, Induced / Q000009:adverse effects / Q000379:methods*; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone