A comparative study of 25µg versus 50µg vaginal misoprostol for induction of labour at term premature rupture of membrane

Authors

  • Renu K. Sinha Department of Obstetrics and Gynecology, Tata Main Hospital, Jamshedpur, Jharkhand, India
  • Santoshi Gupta Department of Obstetrics and Gynecology, Tata Main Hospital, Jamshedpur, Jharkhand, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20171419

Keywords:

Misoprostol, PROM

Abstract

Background: At term, infection remains the most serious complication associated with PROM for the mother and the neonate Induction of labour significantly reduces the risk of maternal and foetal infection. This randomized comparative study has been done to compare the effectiveness and safety of low and high dosage (25 mcg and 50mcg) regimen of vaginal misoprostol for induction in term PROM patients.

Methods: At term, infection remains the most serious complication associated with PROM for the mother and the neonate Induction of labour significantly reduces the risk of maternal and foetal infection. This randomized comparative study has been done to compare the effectiveness and safety of low and high dosage (25 mcg and 50mcg) regimen of vaginal misoprostol for induction in term PROM patients.

Results: PROM to delivery interval was significantly shorter with 50mcg vaginal misoprostol as compared to 25 mcg vaginal misoprostol (15.71±3.29 hours vs. 18.23±3.23 hours, (p value = 0.0023) Number of doses required was less with 50mcg vaginal misoprostol group as compared to 25mcg vaginal misoprostol (1.22±0.42 vs. 1.91±0.80, p value <0.05). 83.6% women in group A and 69.09% women in group B underwent spontaneous vaginal delivery within 24 hours. 3.64% women in group A and 7.27% in group B had instrumental delivery. Caesarean section was performed in 12.27% cases in group A and 23.64% cases in group B. The complication rate was comparable.

Conclusions: 50mcg vaginal misoprostol is more effective and safe for induction of labour at term PROM as compared to 25 mcg vaginal misoprostol 

References

American college of Obstetricians and Gynaecology: Premature rupture of membrane. Practice bulletins No. 139: premature rupture of membranes. Obstet Gynecol. 2013;122(4):918-30.

American College of Obstetricians and Gynaecology. Premature rupture of membranes. ACOG practice bulletin no. 1. Washington, DC: American College of Obstetricians and Gynaecologists. 1998.

RANZCOG College Statement: C-Obs 36. Term Pre-labour Rupture of Membranes (Term PROM). 2013:1-2.

Seaward PG, Hannah ME, Myhr TL, Farine D, Ohlsson A, Wang EE et al. International multicentre term prelabor rupture of membranes study: evaluation of predictors of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term. Am J Obstet Gynecol. 1997;177(5):1024-9

Bharathi A, Kumar KA, Ganga AP. A comparative study of 25 mcg vs. 50mcg of vaginal misoprostol for induction of labour. J South Asian Feder Obst Gynae. 2013;5(3):111-5.

Chan YH. Randomised Controlled Trails (RCTs) – Sample size: Magic Number. Basic Statistics for Doctors. Singapore Med J. 2003;44(4):172-4.

Sample size for a comparative study. Available from: http://www.rnoh.nhs.uk/sites/default/files/sample_size_for_a_comparative _study.pdf.

Girija S, Manjunath AP. Comparison of two dosing regimens of vaginal misoprostol for labour induction: a randomised controlled trial. J Turkish German Gynecol Assoc. 2009;10:220-5.

Singh P, Agrawal S. A comparative study of safety and efficacy of 25mcg VS 50mcg intravaginal misoprostol for induction of labour. Scholars J Applied Med Sci (SJAMS). 2016;4(1A):9-14.

Meydanli MM, Çalıkan E, Burak F, Narin MA, Atmaca R. Labor induction post-term with 25 micrograms vs. 50 micrograms of intravaginal misoprostol. Int J Gynecol Obstetr. 2003;81:249-55.

Diro M, Adra A, Gilles JM, Nassar A. A double blind randomized trial of two dose regimens of misoprostol for cervical ripening and labour induction. The J Makrnol-fetal Med. 1999;8:114-8.

Sanchez-Ramos L, Kaunitz AM, Delke I. Labour induction with 25 microg versus 50 microgintravaginal misoprostol: a systematic review. Obstet Gynecol. 2002;99:145-51.

Has R, Batukan C, Ermis H, Cevher E, Araman A, Kilic G, Ibrahimoglu L. Comparison of 25 and 50 microg vaginally administered misoprostol for pre-induction of cervical ripening and labour induction. GynecolObstet Invest. 2002;53:16-21.

Kreft M, Krähenmann F, Roos M, Kurmanavicius J, Zimmermann R, Ochsenbein-Kölble N. Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol. J Perinat Med. 2014;42(5):603-9.

Ozsoy M, Ozsoy D. Induction of labor with 50 and 100 microg of misoprostol: comparison of maternal and fetal outcomes. Eur J Obstet Gynecol Reprod Biol. 2004;113:41-4.

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Published

2017-03-30

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Original Research Articles