DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20175060

Efficacy of misoprostol over dinoprostone gel as a cervical ripening agent: a comparative study

Pankajkumar B. Nimbalkar, Jaldhara N. Patel, Nilesh Thakor

Abstract


Background: Timely induction of labour could reduce maternal mortality and morbidity as well as assure a delivery of healthy baby. The objective of this study was to evaluate the efficacy of Misoprostol as a cervical ripening agent and its comparison with Dinoprostone gel in terms of success rate, safety, side effects and patient compliance.

Methods: A total of 250 pregnant women requiring induction of labor were recruited. Out of 250 cases, 150 were induced with 50 microgram Misoprostol and 100 cases with 0.5 mg intracervical Dinoprostone gel during September 2014 to August 2017 at the department of Obstetrics and Gynaecology, GMERS Medical College, Dharpur-Patan. Written and informed consent was taken from the patients. Outcome measures, such as change in Bishop's score, need of augmentation, induction delivery interval; complications like hyperstimulation, fever and meconium passage were compared between two groups. Statistical analysis was performed by Epi Info 7.

Results: Age range of the patients was 21 to 35 years. 74.8% of the patients were in 21-25 years age groups. 50.4% patients were multigravida. 57.6% patients had more than 37 weeks of pregnancy. 50.4% of the patients had premature rupture of membrane as indication of labour. The mean Bishop's score for induction was 3.21 in Misoprostol group. 81.3% patients in Misoprostol group and 93% of patients in Dinoprostone group were delivered by vaginal delivery. 60% patients delivered within 6 hours in Misoprostol group. (Misoprostol: 60%, Dinoprostone: 27%, p<0.001). Incidence of thin meconium was 11.3% in Misoprostol group, 9% in Dinoprostone group. In Misoprostol group 3.3 women had fever after induction.

Conclusions: Vaginal misoprostol is more efficacious in cervical ripening and for induction of labor than Dinoprostone.


Keywords


Bishop’s score, Cervical ripening, Dinoprostone, Induction of labour, Misoprostol

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References


Jani PS, Gandhi MR, Thakor N. Efficacy of misoprostol over dinoprostone gel and Foley’s catheter as a cervical ripening agent. Int J Med Sci Public Health. 2015;4:888-92.

Melanie PM, Martin SL, Suzanne L. Uterine rupture associated with use of misoprostol in gravid patient with previous cesarean section. Am J Obst Gynecol. 1999;180:1535-42.

David B, Mora G, Arias F. A randomized comparison between misoprostol and dinoprostone for cervical ripening and labour induction in patient with unfavorable cervices. Obst Gynecol. 1997:89:581-5.

Howard BA, Nayak S. Comparison of the safety and efficacy of intra vaginal misoprostol with those of prostaglandin E2 for cervical ripening and induction of labour. Am J ObstGynecol. 1999;180:1551-9.

Kolderup L, Mclean L. Misoprostol is more efficacious for labour induction than prostagiandinE2 but is it associated with more risk? Am J Obst Gynecol. 1999;180:1543-50.

Deborah WA, Johnes MM. A comparison of misoprostol and PGE2 gel for preinduction cervical ripening and labour induction. Am J Obst Gynecol. 1995;172:1804-10.

Garry D, Fiqueroa R, Kailash RB. Randomized controlled trial of vaginal misoprostol versus dinoprostone vaginal insert for labour induction. J Matern Fetal Neonatal Med. 2003;13(4):254-9.

Agarwal N, Gupta A, Kriplani A, Bhatla N, Parul. Six hourly vaginal misoprostol versus intracervical dinoprostone for cervical ripening and labour induction. J Obstet Gynecol Res. 2003;29(3):147-51.

Ozkan S, Calişkan E, Doğer E, Yücesoy I, Ozeren S, Vural B. Comparative efficacy and safety of vaginal misoprostol versus Dinoprostone vaginal insert in labor induction at term: a randomized trial: Arch Gynecol Obstet. 2009;280(1):19-24.