Comparative Study of Misoprostol Sublingually and Dinoprostone Gel Intracervically for Cervical Ripening and Induction of Labor

Background: Both Prostaglandin E1 and E2 analogues are being used for cervical ripening. The aim of study was to compare the efficacy and safety profile of sublingual misoprostol (PGE1) and intracervical dinoprostone (PGE2) for cervical ripening and induction of labor. Methods: Two hundred nulliparous women with single live fetus and with gestational age of more than 37 weeks admitted for induction of labor were recruited for the study. Patients were randomized to receive either 25g of misoprostol sublingually or dinoprostone gel (0.5mg) intracervically. Results: There was shorter induction to delivery time intervals, less requirement of oxytocin augmentation, higher vaginal delivery rate (81 % vs 76 %) and lower caesarean section rate (19 % vs 24 %) in misoprostol group than dinoprostone gel group. Incidence of tachysystole was higher in misoprostol group than dinoprostone gel group. Maternal and neonatal complications were similar in both the groups. Conclusions: Use of misoprostol in lower dose is a safe and cost-effective method for cervical ripening and induction of labor.