DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20181364

An observational study of 100 cases of 25μg oral misoprostol for induction of labour in term pregnancy

Nidhi S. Gupta, Shetal S. Prajapati

Abstract


Background: Labour induction is a clinical intervention that has the potential to confer major benefits to the mother and new born when continuation of pregnancy poses a risk/danger to the outcome of pregnancy. Misoprostol is an ideal agent for induction of labour, particularly in settings where the use of prostaglandin E2 is not possible owing to lack of availability, facilities for storage, or financial constraints. It is stable at room temperature, relatively inexpensive and can be given via several routes (oral, vaginal, sublingual, and buccal).

Methods: It is an observational study of 100 cases conducted in the labour room of a Tertiary Care Government Hospital, Rajkot over a span from January 2016 to March 2017. After patient selection as per inclusion criteria and written informed consent after evaluating patients were enrolled in the study. Tablet misoprostol 25 microgram given orally every 4 hourly with maximum of 5 doses till the patient was in active stage of labour.

Results: Maximum patients delivered by a single dose of Tab. Misoprostol (35%), the mean induction delivery interval was 11.44 hours. Most of the women delivered by vaginal route (88%) without any maternal complications like PPH, cervical/vaginal tear and uterine rupture. Only 4 cases out of 100 of failed induction for which LSCS was taken. Eight babies were admitted in NICU for MSL and had good prognosis. The most common side effect of the drug was nausea (15%) followed by fever and vomiting. 69% patients did not have any adverse drug reaction.

Conclusions: Thus, induction of labour with oral misoprostol reduces the LSCS rates, lesser induction delivery interval and has good fetal outcome. The drug is well tolerated by the patients orally and has very few side effects.


Keywords


Labour induction, Low dose oral misoprostol, Postdatism, PROM

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References


Calder AA. Induction and augmentation of labour. In: Keith Edmands (editor). Dewhurts Textbook of Obstetric and Gynaecology for Postgraduate, 6th Ed. London: Blackwell; 1999:255-7.

WHO Global Survey on Maternal and Perinatal Health. Induction of labour data. Geneva, World health Organization, 2010.

Gemzell-Danielsson K, Marions L, Rodriguez A, Spur BW, Wong PYK, Bygdeman M. Comparison between oral and vaginal administration of misoprostol on uterine contractility. Obstet Gynaecol. 1999;93:275-80.

Aronsson A, Bygdeman M, Gemzell-Danielsson K. Effects of misoprostol on uterine contractility following different routes of administration. Hum Reprod. 2004;19:81-4.

WHO model list of essential medicines:15th list, March 2007. Geneva: World Health Organization; 2007.

Morris M, Bolnga JW, Verave O, Aipit J, Rero A, Laman M. Safety and effectiveness of oral misoprostol for induction of labour in a resource-limited setting: a dose escalation study. BMC Pregnancy and Childbirth. 2017 Dec;17(1):298.

Nahar A, Sultana R, Akter FM, Ferdausi M, Yusuf MA, Nahar K. Use of Misoprostol in Term pregnant women for Good Delivery Outcome: Experience at a tertiary care Hospital in Dhaka. J Sci Found. 2016;12(2):22-6.

Syed S, Chaudhri R, Rizvi F, Afzal M. Oral misoprostol for induction of labour. J Coll Physicians Surg Pak. 2010;20(2):102-5.

Alfirevic Z, Weeks A. Oral misoprostol for induction of labour. Cochrane Database Syst Rev. 2001;2(001338).

Deshmukh VL, Rajamanya AV, Yelikar KA. Oral Misoprostol Solution for Induction of Labour. J Obstet Gynecol India. 2017;67(2):98-103.

Bishop EH. Pelvic scoring for elective induction. Obstet Gynecol. 1964;24:266-8.