A comparative study to assess the efficacy of dinoprostone and misoprostol in labour induction

Neelima V. Nair, Divya R. Prasad, Geethanjali S. Mohan


Background: Induction of labour is the non-spontaneous initiation of uterine contractions, prior to their spontaneous onset leading to progressive effacement and dilation of cervix and delivery of the baby. The objective of this study to compare efficacy of induction of labour with dinoprostone and misoprostol with respect to induction delivery interval, oxytocin augmentation, type of delivery and cost effectiveness.

Methods: 200 Patients admitted to labour ward of Sree Gokulam Medical College and Research Foundation, Vejaramoodu, Kerala, India with an indication of induction of labour and unfavorable cervices were randomly assigned to receive either intravaginal misoprostol or intracervical dinoprostone between December 2012 and May 2014.

Results: Average induction to delivery interval among misoprostol group was 21.6+4.2 hours and that of dinoprostone was 29.1+4.2 hours. Dinoprostone group had significant longer duration than misoprostol group in induction delivery interval.64% of misoprostol group had spontaneous onset of labour whereas only 31% of dinoprostone group had spontaneous labour onset. Mean bishop’s score change over 6 and 12 hours was significantly greater in the misoprostol group. There was no significant difference in the mode of delivery or rate of caesarean section in both the groups.

Conclusions: Misoprostol is an effective and economical drug for induction of labour, which is easy to preserve and administer. It shortness the induction delivery interval with less need for oxytocin compared to dinoprostone.


Misoprostol, Dinoprostone, Induction of labour, Oxytocin

Full Text:



Arulkumaran. The management of labour. 3rd ed. 2011.

Meyer M, Pflum J, Howard D. Outpatient misoprostol compared with dinoprostone gel for preinduction cervical ripening: a randomized controlled trial. Obstet Gynecol. 2005;105(3):466-72.

Calder AA, Loughney AD, Weir CJ, Barber JW. Induction of labour in nulliparous and multiparous women: a UK, multicentre, open-label study of intravaginal misoprostol in comparison with dinoprostone. BJOG Int J Obstet Gynaecol. 2008;115(10):1279-88.

Chitrakar NS. Comparison of Misoprostol versus Dinoprostone for pre-induction cervical ripening at-term. J Nepal Health Res Counc. 2012;10(1):10-5.

Oliveira TA, Melo EMV, Aquino MMA, Neto CM. Efficacy of dinoprostone and misoprostol for labor induction in nulliparous women. Rev Bras Ginecol E Obstetrícia Rev Fed Bras Soc Ginecol E Obstetrícia. 2011;33(3):118-22.

Chang CH, Chang FM. Randomized comparison of misoprostol and dinoprostone for pre-induction cervical ripening and labor induction. J Formos Med Assoc Taiwan Yi Zhi. 1997;96(5):366-9.

Neiger R, Greaves PC. Comparison between vaginal misoprostol and cervical dinoprostone for cervical ripening and labor induction. Tenn Med J Tenn Med Assoc. 2001;94(1):25-7.

Ramsey PS, Meyer L, Walkes BA, Harris D, Ogburn PL, Heise RH, et al. Cardiotocographic abnormalities associated with dinoprostone and misoprostol cervical ripening. Obstet Gynecol. 2005;105(1):85-90.

Gemund NV, Scherjon S, LeCessie S, Leeuwen JHS, Roosmalen J, Kanhai HHH. A randomised trial comparing low dose vaginal misoprostol and dinoprostone for labour induction. BJOG Int J Obstet Gynaecol. 2004;111(1):42-9.

Nanda S, Singhal SR, Papneja A. Induction of labour with intravaginal misoprostol and prostaglandin E2 gel: a comparative study. Trop Doct. 2007;37(1):21-4.