Publication:

Comparison of sublingual versus vaginal routes of misoprostol in induction of labor

Background Induction of labor can be defined as an intervention intended to artificially initiate uterine contractions resulting in progressive effacement and dilatation of cervix. Present study was under taken to compare the efficacy of sublingual versus vaginal routes of administration of misoprostol for induction of labor.

Methods Prospective observational study conducted from January 2010 to January 2011 in the Department of Obstetrics and Gynecology at Karnataka Institute of Medical Sciences, Hubli, Karnataka, India. The patients were selected from either antenatal ward or emergency admission to labor room. 100 women were selected for the study. 50 women in sublingual group and 50 in vaginal group. Main outcome measured were the number of doses of misoprostol administered, induction to delivery interval, incidence of cesarean sections, uterine hyperstimulation, meconium stained liquor and admission to NICU.

Results Mean number of misoprostol doses required in sublingual group was significantly less compared to vaginal group (p=0.0001). Mean induction to delivery time interval was significantly less in sublingual group (p=0.008). The incidence of cesarean sections, major side effects and vaginal delivery were similar in both the group. Neonatal outcomes of both groups were comparable.

Conclusions Misoprostol was effective in induction of labor when administered by either sublingual or vaginal route. Sublingual route had significantly less induction to delivery time interval and less doses were required. Sublingual route seems to have better efficacy than vaginal route. Misoprostol seems to be acceptable to the patients and is an option to be considered to induce labor at term.