Comparison of Misoprostol and Dinoprostone Gel for Induction in Prelabor Rupture of Membranes at Term

Abstract

Background: The aim of the study was to compare the safety and efficacy of vaginal misoprostol with dinoprostone gel for induction of labor in prelabor rupture of membranes at term pregnancy.

Methods: This is a prospective study conducted in the Department of Obstetrics and Gynaecology, at Sri Devraj Urs Medical College from December 2010 to September 2012. One hundred patients were induced with either misoprostol or dinoprostone gel using computer-generated randomized table. The study had two groups. Group I had 50 cases of primigravida, where 25 cases were induced with misoprostol and another 25 were induced with dinoprostone gel. Group II had 50 cases of multigravida, where 25 cases were induced with misoprostol and the rest 25 were induced with dinoprostone gel. Twenty-five microgram misoprostol was inserted vaginally every sixth hourly for maximum of six doses and 0.5 mg dinoprostone gel was used intracervically every sixth hourly for maximum of three doses. The primary outcome measured was induction to delivery interval and the secondary outcomes included mode of delivery, and maternal and neonatal outcome.

Results: Among the patients induced, both the groups were comparable with respect to age, parity, booking status, gestational age, and pre-induction Bishops score. There was no significant difference in induction to delivery interval between both the groups. The induction to delivery interval in misoprostol group was 6.65 hours and that in dinoprostone group was 6.89 hours. In primigravida, the induction to delivery interval in misoprostol group was 7.74 hours and 7.08 hours in dinoprostone group and in multigravida, the induction to delivery interval in misoprostol group was 5.55 hours and in dinoprostone group was 6.71 hours. In primigravida, dinoprostone has shorter induction to delivery interval compared to misoprostol. In multigravida, misoprostol has shorter induction to delivery interval compared to dinoprostone. There was no difference in mode of delivery in both the groups. There was no significant difference in maternal outcome and neonatal outcome among both the groups.

Conclusion: Vaginal misoprostol is equally efficacious in labor induction and demonstrates a similar fetal and maternal safety profile when compared with dinoprostone gel.




J Clin Gynecol Obstet. 2015;4(4):302-306
doi: http://dx.doi.org/10.14740/jcgo321w

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