Comparative study of intra vaginal misoprostol (PGE1) with intracervical dinoprostone (PGE2) gel for induction of labour

Bina M. Raval, Nainesh S. Zalavadiya, Pushpa A. Yadava, Shital T. Mehta


Background: Labour is a final consequence of Pregnancy and is inevitable. The timing of labour may vary widely but it will happen sooner or later. The aim of the present research was to study the safety, efficacy and effect of intra vaginal Misoprostol and intra cervical Dinoprostone gel for induction of labour.

Methods: 100 patients who required labour of induction were included in this prospective cross-sectional study from September 2017- March 2018. 50 patients of them received 25mcg tablet misoprostol intravaginal and 50 patients of them required 0.5mg intracervical dinoprostone gel and doses were repeated every 6 hourly for up to maximum 6 doses for Misoprostol and 3 doses for Dinoprostone gel.

Results: The majority of patients had gestational age above 40 weeks and between 37-40 weeks in PGE2 and PGE1 group respectively. The mean time taken for the onset of labour was less in Misoprostol than in Dinoprostone group (43.22min v/s 1 hr40 min). The mean time taken for induction to active phase of labour (1hr 42min v/s 4hr 10min) and active phase to delivery (3hr 6min v/s 4hr54min) was less in Misoprostol than Dinoprostone group. The mean time required for induction to delivery was less in Misoprostol group (5hr 2min v/s 11hrs). Requirement of oxytocin for augmentation of labour was almost equal in both groups. Caesarean section rate was less in Misoprostol group (10% v/s 22%). Maternal side effects were minimal in either groups and neonatal outcome was good in both the groups.

Conclusions: Both Misoprostol and Dinoprostone gel are safe, effective for cervical ripening and induction but Misoprostol is more cost effective and stable at room temperature.


Dinoprostone, Induction of labour, Misoprostol

Full Text:



Sahu L, Chakravertty B. Comparison of prostaglandin E 1(misoprostol) with prostaglandin E 2 (dinoprostone) for labor induction. J Obstet Gynecol India. 2004;54:139-42.

Patil KP, Swamy MK, Rao RK. Oral misoprostol vs intra-cervical dinoprostone for cervical ripening and labour induction. J Obstet Gynecol India. 2005;55(2):128-31.

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.

Witter FR. Prostaglandin E2 preparations for preinduction cervical ripening. Clin Obstetr Gynecol. 2000 Sep 1;43(3):469-74.

Arias F. Pharmacology of oxytocin and prostaglandins. Clin Obstet Gynecol. 2000;43(3):455-68.

American College of Obstetricians and Gynecologist. New U.S. food and drug administration labelling on Cytotec (Misoprostol) use and pregnancy. Committee opinion Washington. DC: ACOG. 1999;28.

Agarwal N, Gupta A, Kriplani A, Bhatla N. Six hourly vaginal misoprostol versus intracervical dinoprostone for cervical ripening and labor induction. J Obstetr Gynaecol Res. 2003 Jun 1;29(3):147-51.

Yadav S, Chandwaskar N. Comparative study of misoprostol sublingually and dinoprostone gel intracervically for cervical ripening and induction of labor. Int J Reprod Contracept Obstet Gynecol. 2017 Jul 26;6(8):3624-7.

Garry D, Figueroa R, Kalish RB, Catalano CJ, Maulik D. Randomized controlled trial of vaginal misoprostol versus dinoprostone vaginal insert for labor induction. J Maternal-Fetal Neonatal Med. 2003 Jan 1;13(4):254-9.

Liu A, Lv J, Hu Y, Lang J, Ma L, Chen W. Efficacy and safety of intravaginal misoprostol versus intracervical dinoprostone for labor induction at term: A systematic review and meta‐analysis. J Obstetr Gynaecol Res. 2014 Apr 1;40(4):897-906.

Herabutya Y, O‐Prasertsawat P, Pokpirom J. A comparison of intravaginal misoprostol and intracervical prostaglandin E2 gel for ripening of unfavorable cervix and labor induction. J Obstetr Gynaecol Res. 1997 Aug;23(4):369-74.

Windrim R, Bennett K, Mundle W, Young DC. Oral administration of misoprostol for labor induction: a randomized controlled trial. Obstetr Gynecol. 1997 Mar 1;89(3):392-7.