Publication:

Efficacy of 25 mcg sublingual versus vaginal misoprostol for induction of labor

Background Currently, to decrease the incidence of contractility disturbances and neonatal complications, 25 mcg of vaginal misoprostol is recommended for induction of labor. American College of Obstetrics and Gynecology suggested 25 mcg every 4-6 hourly by vaginal route. But till date, there is no consensus either for route or dosage. The present study was to compare the efficacy and suitability of low dose (25 μg) sublingual misoprostol for induction of labor in term pregnancy as compared with the same dose given vaginally.

Methods This was a hospital based unblinded randomized prospective study conducted in the Department of Obstetrics and Gynecology in collaboration with the Department of Pediatrics, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh from February 2015 to November 2016.The study involved pregnant women attending O.P.D. or admitted in the labor room. Patients were randomly allocated into two groups: Group 1 received 25 mcg of misoprostol sublingually and Group 2 received 25 mcg of misoprostol 4 hourly vaginally to a maximum of 5 doses. Maternal and neonatal outcomes were analysed.

Results There is no difference between groups for indications for induction of labor, mean induction to the onset of contraction interval and mean interval from the initiation of induction to the delivery. No significant difference in indication for caesarean section and number of doses. No significant differences in neonatal outcomes.

Conclusions 25µg misoprostol administered by sublingual route is equally efficacious as by vaginal route for induction of labor at term.