title: Oral versus vaginal misoprostol for induction of labor in Enugu, Nigeria: a randomized controlled trial.
abstract: OBJECTIVE
  The study aimed at comparing the effectiveness and maternal satisfaction of oral misoprostol with vaginal misoprostol for induction of labor at term.
  
  
  METHODS
  A randomized controlled trial of 140 term pregnant women at the University of Nigeria Teaching Hospital Enugu, Nigeria, was conducted from April 2011 to May 2012. The women were equally randomized into two groups (A and B) to receive oral and vaginal misoprostol, respectively.
  
  
  RESULTS
  The vaginal route reduced the mean induction-vaginal delivery interval by four-and-half hours (20.7 ± 12.1 vs. 16.2 ± 10.4; mean difference: 4.50, 95% CI 0.63-0.82; p = 0.02). Furthermore, the mean dose of misoprostol required to achieve induction of labor and the mean duration of oxytocin augmentation when indicated were significantly less in the vaginal group than in the oral group (2.5 ± 1.3 vs. 2.0 ± 1.1; mean difference: 0.50, 95% CI 0.10-0.90; p = 0.02 and 4.6 ± 3.2 vs. 3.4 ± 3.1; mean difference: 1.20, 95% CI 0.15-0.23; p = 0.03 respectively). However, neonatal complications and maternal satisfaction were similar between the two groups.
  
  
  CONCLUSIONS
  Both routes of administration are effective in the induction of labor at term and have comparable maternal satisfaction. However, the vaginal route has the added advantage of shorter induction-delivery interval among others, and thus should be highly considered when induction of labor is indicated at term.
authors.affiliation: Department of Obstetrics/Gynaecology, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria.
authors.forename: Paschalina Constance
authors.initials: PC
authors.lastname: Ezechukwu
authors.forename: Emmanuel Onyebuchi
authors.initials: EO
authors.lastname: Ugwu
authors.forename: Samuel Nnamdi
authors.initials: SN
authors.lastname: Obi
authors.forename: Chibuike Ogwuegbu
authors.initials: CO
authors.lastname: Chigbu
mesh_terms: D000282:Administration, Intravaginal; D000284:Administration, Oral; D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D007743:Labor, Obstetric / Q000187:drug effects*; D016595:Misoprostol / Q000008:administration & dosage*; D009549:Nigeria; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D012959:Socioeconomic Factors; D047929:Term Birth
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin