Comparative study of sublingual misoprostol (PGE1) versus intracervical dinoprostone (PGE2) for induction of labour in nulliparous postdated pregnancy

Author(s): Swopna Susmita Majhi1, Mahija Sahu2, Shantisena Mishra3, Saroj Shekhar Rath4, Swapna Mahapatra5
1Junior Resident, Department of Obstretics & Gynecology, MKCG Medical College, Berhampur, Odisha, India.
2Professor, Department of Obstretics & Gynecology, MKCG Medical College, Berhampur, Odisha, India.
3Professor, Department of Pediatrics, Bhima Bhoi Medical College Balangir Odisha, India.
4Associate Professor, Department of Pediatrics, MKCG Medical College Berhampur. Odisha, India.
5Assistant Professor, Department of Pharmacology, MKCG Medical College, Berhampur, Odisha, India.
Copyright © Swopna Susmita Majhi, Mahija Sahu, Shantisena Mishra, Saroj Shekhar Rath, Swapna Mahapatra. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: To compare the efficacy of sublingual misoprostol tablet and intracervical dinoprostone gel for induction of labour in nulliparous postdated pregnancy and assess the maternal and fetal outcome after induction.
Methodology: It is a prospective randomized controlled study conducted over a period of 2 years (nov 2020 to nov 2022), in dept. of obstetrics and gynecology, mkcg mch. Out of 200 cases 100 cases were given sublingual misoprostol tablet (Group 1) and rest were given intracervical dinoprostone gel (Group 2). The efficacy of both the drugs were assessed by favorability of Bishop’s score at 24 hours, need of augmentation with oxytocin, drug administration to delivery interval, mode of delivery, APGAR score, NICU admission, maternal complication and number of failed induction, data was analyzed description statistics and chi square test.
Result: Mean Drug administration to delivery interval was shorter and significant (18. 53hours vs 20.42) hours, p-value 0.0018). Need for augmentation (48 vs 65, p-value 0.0125), failed induction rate (5 vs 11), post-delivery mean blood loss( 436.50mL vs 516 mL, p value- 0.0173) were significantly lower with misoprostol group. NICU admission was lower in dinoprostone group (7 vs 14).
Conclusion: Sublingual misoprostol tablet is efficacious in inducing labour, with shorter drug administration to induction interval, and higher vaginal delivery rate as compared to dinoprostone gel.

Keywords: Dinoprostone gel; Misoprostol tablet; Induction of labour; Drug administration to delivery interval.