Publication:

Can prostaglandin E1 (Misoprostol) be an alternative to prostaglandin E2 (PGE2) for induction of labor in prelabor rupture of membranes (PROM) after 34 weeks period of gestation

Background To compare efficacy and safety of prostaglandin E1 (misoprostol) to prostaglandin E2 (PGE2) for induction of labor in prelabor rupture of membranes (PROM) after 34 weeks period of gestation and its use as an alternative to PGE1.

Methods 80 women were recruited in this prospective interventional study who was admitted with PROM after 34 weeks of period of gestation for delivery. These women who were planned for induction of labor were alternately assign into two groups i.e. Misoprostol group (n = 40) who received Tab misoprostol 50 mcg orally 4 hourly (h) maximum of five doses and PGE2 group (n = 40) received PGE2 gel intracervically every 6 h for maximum of 3 doses. Analysis regarding safety and efficacy of the drugs was done with regards to maternal and perinatal outcome.

Results Out of 80 women, 40 received misoprostol and 40 received PGE2 gel. The intervention to induction interval was significantly less in PGE2 group (p-0.004) whereas the induction to delivery interval was similar in both groups (p- 0.628). Significant number of women delivered vaginally without need for oxytocin in misoprostol group, (p- 0.039) however there was no statistical difference in both groups as far as overall vaginal deliveries and caesarean section are concerned. Comparable neonatal and maternal morbidities were noted in both groups.

Conclusions Oral misoprostol can be used as an alternative to PGE2 gel for induction of labor after 34 weeks of period of gestation in women with PROM as it was found to be safe and effective in achieving vaginal deliveries with reduced need for oxytocin, without increasing maternal and neonatal morbidity.