Comparative Observational Study of Low Doseintravaginal Misoprostol Tablet Versus Intracervical Dinoprostone Gel for Induction of Labor

Aim: To compare the efficacy and safety of low dose vaginal Misoprostol (25 mcg) and intracervical Dinoprostone gel for induction of labor. Method: An observational study was carried out wherein subjects in group 1 received intracervical Dinoprostone gel(0.5mg) and the subjects in group 2received tab Misoprostol 25 mcg per vaginally, 6 hourly for maximum 3 doses (n=48 in each group). Result: The primary outcome, i.e. number of vaginal deliveries within 12 hours of 1st dose of inducing agent was higher in Misoprostol group (31.8 % in group 1 vs 50 % in group 2, p=0.07) The mean IAL interval was shorter in Misoprostol group (9.88 hours in group 1 vs 6.8 in group 2, p=0.6). Statistically significant shorter duration of oxytocin use in Misoprostol group (7.85 hours in group 1 vs 5.16 hours in group 2, p=0.013). There was no significant difference between the mean IDI (14.53 hours in group 1 vs 17.01 hours in group 2, p=0.2) and the maternal and neonatal outcomes of the 2 groups. Conclusion: Low dose (25 mcg) intravaginal Misoprostol appears to be a safe, effective and an economical alternative drug to routinely used Dinoprostone gel for induction of labor, especially in developing countries with low resource settings.