Is low dose vaginal misoprostol better than dinoprostone gel for induction of labor: a randomized controlled trial.
OBJECTIVE
To compare the efficacy and safety profile of low dose vaginal misoprostol with dinoprostone gel for induction of labor in term pregnancies.


METHODS
The study was conducted at Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital on 100 pregnant women with term pregnancy after application of inclusion and exclusion criteria. The women were randomized in 2 groups of 50 women each. Group I received misoprostol 25μg at every six hour vaginally for a maximum of five doses for induction of labor; while group II received dinoprostone gel 0.5 mg every six hourly for a maximum of three doses. Maternal outcomes such as mode of delivery and induction delivery interval; and fetal outcomes such as APGAR score and incidence of NICU admission were assessed in both the groups. Statistical analysis was done using student t-test and chi-square test.


RESULTS
There was no significant difference in the mean induction to delivery interval in both the groups (14.32±0.13 hours in Group I and 14.92±0.18 hours in Group II, p=0.75), mode of delivery, indication of cesarean section and perinatal outcome. However, significant difference was observed in requirement of oxytocin augmentation in both the groups (32% in Group I and 68% in Group II, p=0.005).


CONCLUSIONS
Vaginal misoprostol in low doses is similar in efficacy and safety to dinoprostone gel for cervical ripening and labor induction in term pregnancy.
Ex Assistant Professor, Department of Obstetrics and Gynecology, LHMC & SSKH (Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital) , New Delhi, India .
Monika
M
Madaan
Assistant Professor, Department of Obstetrics and Gynecology, LHMC & SSKH , New Delhi, India .
Swati
S
Agrawal
Professor, Department of Obstetrics and Gynecology, LHMC & SSKH , New Delhi, India .
Manju
M
Puri
Ex. Assistant Professor, Department of Obstetrics and Gynecology, LHMC & SSKH , New Delhi, India .
Aruna
A
Nigam
GDMO, Department of Obstetrics and Gynecology, LHMC & SSKH , New Delhi, India .
Harvinder
H
Kaur
Director Professor, Department of Obstetrics and Gynecology, LHMC & SSKH , New Delhi, India .
Shubha Sagar
SS
Trivedi
Dinoprostone; Induction; Labor; Misoprostol