DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174422

To compare the efficacy and safety of intravaginal misoprostol and intracervica lcervigel for induction of labour

Nivedita Malik

Abstract


Background: This randomized prospective study was conducted in the department of obstetrics and Gynaecology Batra Hospital and Medical Research centre from 1st March to 30th April 2008 to compare the safety and efficacy of intravaginal misoprostol and intracervical dinoprostone gel (cervigel) for cervical ripening and induction of labour.

Methods: 80 women were recruited in the study. 40 women were administered misoprostol tablet 25ug vaginally while the other 40 were given intracervical cervigel.

Results: A total of 85.1% (68 patients) delivered vaginally (33 in the misoprostol group and 35 in the cervigel group) i.e. spontaneous vaginal and assisted vaginal deliveries. The mean interval from start of induction to vaginal delivery was 707.63+146.511 minutes in the misoprostol group and 833.13 +144.36 minutes in the cervigel group with p=0.001 which was significant statistically. Though both the groups showed a favourable change in Bishop’s score after induction but this was not statistically significant. However, the number of doses required in both the groups to produce an effect on cervical ripening and dilation was statistically significant p=0.001, cervigel group requiring lesser dose (42.5% in cervigel vesus 7.5% in the misoprostol group after administration of 1st dose).

Conclusions: Both 25ug misoprostol intravaginal and dinoprostone gel intracervical are equally effective and safe for cervical ripening and induction of labour.


Keywords


Dinoprostone, Induction of labour, Misoprostol

Full Text:

PDF

References


Riskin-Mashiah S, Wilkins (1999) cervical ripening Obstetr Gynecol clinics of N America. 1999;26:243-57.

Calder A. Review prostaglandine use in labour induction BJOG. 1997;104:2-7.

Wing DA. Labour induction with misoprostol Am J OG. 1999;181:339-45.

Blanchard K, Shelly C, Winikoff B, Gaines G, Kabani G, Shannon C. Misoprostol for women’s Health: Section V, Chapter 20:470-81.

Goepfert and colleagues 2001 Williams Obstetrics 22nd editionMcGraw-Hill medical publishing divition: section V, Chapter 20:470-81.

Hall R. Durate-Gardea M. Harlass F. Oral versus vaginal misoprostol for labour induction. Obstet Gynecol. 2002:99-8.

Mundle WR, Young DC, vaginal misoprostol for induction of labour: a randomized controlled trail. Obstet Gynecol. 1996;88:521-5.

Barthe JL, Comino-Delgado R, Gercia-Benasach F. Oral misoprostol and intracervicaldinoprostone for cervical ripening and labour induction: a randomized comparison Obstetgynecol. 2000;96:465-9.

Van Gemund N, Scherjon S, LeCessie S. a randomized trail comparing low dose vaginal misoprostol and dinoprostone for labour induction. B J Obstet Gynecol. 2004;111:42-9.

Gragson S, Water Stone a randomized trail comparing misoprostol with dinoprostone gel. B J Obstet Gynecol. 2005;112(4):438-44.

Chuck FJ, Huffakerr BJ. Labour induction with intravaginal misoprostol versus intrecervical prostaglandin E2 gel AM J Obstet Gynecol 1995;173:1137-42.

Surbek DV, Boesiger H, Hoesli I, Pavic N, Holzgrevfee W. A double blind comparison of the safety and efficacy of intravaginal misoprostol and prostaglandin E2 to induce labour. Am J Obstet Gynecol. 1997;177:1018-23.

Rowland S, Bell R. Randomized controlled trail of misoprostol versus dinoprostone for cervical ripening and induction in term pregnancy. Aust NZ J Obstet Gynecol. 2001;41(2):145-52.

Moodley J, Venkatchalam to compare safety and efficacy of misoprostol and cervigel for labour induction. South African Med J. 2003;93(5):371-4.

Blanchette HA, Nayak S, Erasmus S. Comparison of the safety and efficacy of intravaginal misoprostol (prostaglandin E 1) with those of dinoprostone (prostaglandin E 2) for cervical ripening and induction of labor in a community hospital. American J Obstetrics Gynecol. 1999;180(6):1551-9.

Oza A, Shah JM, Mewada B, Thaker R. A comparative study between PGE1 and PGE2 for induction of labour in premature rupture of membrane at term. Internat J Reproduct Contracept Obstetr Gynecol. 2016;5(1):202-5.

Murthy BK, Arkalgud MS. Misoprostol alone versus a combination of Dinoprostone and Oxytocin for induction of labour. J Obstet Gynec India. 2006;56(5):413-6.

Sheela CN, Mhaskar A, George S. Comparison of vaginal misoprostol and oral misoprostol with intracervical dinoprostol gel for induction of labour at term. J Obstet Gynecol India. 2007;57(4):327-0.

Danielian P, Porter B, Gerri N, Summers J, Templeton A. Misoprostol for induction of labour at term: A more effective agent than dinoprostone vaginnal gel Br J Obstet Gynecol. 1999;106:793-7.

Wing DA, Jones MM, Rahall A, Goodwin TM, Paul RH, Misoprostol: An effective agent for cervical ripening and labour induction. Am J Obstet Gynecol. 1995;172:1811-6.

Hofmeyer GJ, Gulmezoglu AM. Alfirevic Z. Misoprostol for induction of labour: a systematic review. Br J Obstet Gynaecol. 1999;106:798-803.