Comparison of the efficacy and safety of sublingual misoprostol (PGE1) versus intracervical dinoprostone (PGE2) for induction of labour: a prospective study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20253520Keywords:
Dinoprostone gel, Induction of labour, Misoprostol, ProstaglandinsAbstract
Background: Induction of labour is indicated when the benefits of induction to either mother or fetus outweigh those of pregnancy continuation. Various mechanical methods include use of extra amniotic saline infusion, artificial rupture of membranes, balloon tipped catheter, natural and synthetic laminaria or stretch sweep method. Pharmacological methods are mainly using prostaglandins either Dinoprostone (PGE2) or Misoprostol (PGE1). This study aimed to compare the efficacy and safety of sublingual Misoprostol (PGE1) versus intracervical Dinoprostone (PGE2) for induction of labour and to compare maternal and perinatal outcome in both groups.
Methods: In this study, 250 antenatal women with 35 weeks or more period of gestation with a single live fetus, cephalic presentation were included for induction of labour.125 women received 25mcg misoprostol sublingually (group A) and 125 women received 0.5mg of dinoprostone intracervically (group B).
Results: There was shorter induction to active phase interval (7.68±3.39 vs 11.42±5.43 hours), induction to delivery intervals (11.46±3.46 vs 16.23±5.61 hours) and less requirement of oxytocin augmentation (25.6% vs 73.6%) in misoprostol group than dinoprostone group. Mode of delivery, maternal and neonatal complications were similar in both groups.
Conclusions: Use of sublingual misoprostol in lower dose is a safe and cost-effective method for induction of labour.
Metrics
References
Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman B, et al. Labour induction. In: Williams Obstetrics. 24th ed. New York: Mc Grew Hill; 2014:523-4.
Arias F, Dftary SN, Bhide AG. Arias’ practical guide to high risk pregnancy and delivery. In: Abnormal labour and delivery. 3rd ed. Amsterdem: Elsevier; 2008:373-90.
Weeks AD, Navaratnam K, Alfirevic Z. Simplifying oral misoprostol protocols for the induction of labour. BJOG. 2017;124(11):1642-5. DOI: https://doi.org/10.1111/1471-0528.14657
Bakker R, Pierce S, Myers D. The role of prostaglandins E1 and E2, dinoprostone, and misoprostol in cervical ripening and the induction of labor: A mechanistic approach. Arch Gynecol Obstet. 2017;296(2):167-79. DOI: https://doi.org/10.1007/s00404-017-4418-5
Chitrakar NS. Comparison of misoprostol versus dinoprostone for pre-induction cervical ripening at-term. J Nepal Health Res Counc. 2012;10:10-5.
Yadav S, Chandwaskar N. Comparative study of misoprostol sublingually and dinoprostone gel intracervically for cervical ripening and induction of labour. Int. J Reprod Contracept Obstet Gynecol. 2017;6(8):3624-7 DOI: https://doi.org/10.18203/2320-1770.ijrcog20173497
Acharya R, Chaudhari P, Choudhary A, Sharma A, Jain S. Mifepristone as cervical ripening agent for labor induction in women with previous one caesarean section. Int J Med Res Rev. 2016;4(4):624-9. DOI: https://doi.org/10.17511/ijmrr.2016.i04.25
Veena B, Rajinish S, Leeberk RI, George EC. Sublingual misoprostol (PGE1) versus intracervical dinoprostone (PGE2) gel for induction of labour: A randomized control trial. J Obstet Gynecol India 2016;66(Suppl1):122-8. DOI: https://doi.org/10.1007/s13224-015-0820-8
Weeks A, Faúndes A. Misoprostol in obstetrics and gynecology. Int J Gynecol Obstet. 2007;99(2):S156-9. DOI: https://doi.org/10.1016/j.ijgo.2007.09.003
Parveen S, Khateeb ZA, Mufti SM, Shah MA, Tandon VR, Hakak S, et al. Comparison of sublingual, vaginal, and oral misoprostol in cervical ripening for first trimester abortion. Ind J Pharmacol. 2011;43(2):172-5. DOI: https://doi.org/10.4103/0253-7613.77356
Panchal PH, Sheth MH, Shah SR, Mehta AV. Comparative study of misoprostol sublingually and dinoprostone gel intracervically for cervical ripening and induction of labor. IJSR 2019;8(11).