JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES

Abstract

Background: To determine and compare the efficacy and safety of 25 µg and 50µg of intravaginal misoprostol for induction of labor at term and to study the maternal and fetal outcome in both groups. Methods: This prospective study was conducted in R.L.Jalappa Hospital and Research Centre, Kolar. Total of 200 cases meeting inclusion criteria were divided in to Group A and Group B who were induced with 25µg and 50µg of misoprostol intravaginally respectively and dose was repeated every sixth hourly interval till the patient gets adequate uterine contractions or cervical dilatation of ≥ 3cms or a maximum of 6 doses. PGE2 or oxytocin was used for delivery if required. Total dose of induction, induction delivery interval, mode of delivery, maternal and fetal outcome were recorded. The collected data was analyzed using student's’ test and chisquare test. Results: Mean number of doses required and mean induction delivery interval was significantly less in 50µg group when compared to 25µg group (1.76±0.77 vs. 2.13±1.01, p=0.013) and (12.98±4.71 vs. 16.07±6.71 hours, p=0.001) respectively. Oxytocin augmentation was required less frequently in 50µg group B as compared to 25µg group A (35.2% vs. 70.1%, p <0.001**). Meconium stained liquor and fetal heart rate abnormalities were more among 50µg group compared to 25µg group (p=0.022* and p= 0.021*respectively). Maternal adverse effects were more common among 50µg group (11% vs 30%, p=0.001). Babies with low Apgar score, requiring resuscitation and NICU care were significantly higher in 50µg group. Conclusion: The intravaginal misoprostol used for induction of labor as 50 µg is more efficacious than 25µg of intravaginal misoprostol but it appears to be less safe both for the mother and the fetus.

Key words: Induction of labor, Meconium, Misoprostol.