Sublingual versus oral misoprostol for induction of labour in prelabour rupture of membranes at term.

Abstract

OBJECTIVE:

To compare the efficacy of sublingual with oral misoprostol for induction of labour in primigravida with prelabour rupture of membranes at term.

STUDY DESIGN:

Randomized controlled trial.

PLACE AND DURATION OF STUDY:

Department of Obstetrics and Gynaecology Unit-II, Sir Ganga Ram Hospital, Lahore, from June 2004 to January 2006.

METHODOLOGY:

The study included 100 primigravidas with singleton pregnancy at term, having pre-labour rupture of membranes and unfavourable Bishop score with no contraindication of induction of labour, vaginal delivery or misoprostol use. The cases were randomized into two equal groups, A and B. Women in the group A were given 100 microg of misoprostol orally at an interval of 4 hours to a maximum of 2 doses while patients in the group B were prescribed the medicine sublingually (50 microg, 4 hourly, maximum of 2 doses). Induction to delivery interval, mode of delivery and fetomaternal complications were main outcome measures of the study.

RESULTS:

In the sublingual misoprostol group (B), 92% women delivered within 12 hours of induction while 84% of subjects delivered in this time period in oral group (A, p < 0.05). There was no failed induction in either group. Regarding dosage, 64% of women delivered with single dose in group B while only 32% delivered with single dose in group A (p < 0.05). The frequency of vaginal delivery was 92% in group B versus 80% in group A, while rate of caesarean section was 8% in the group B and 20% in the group A, which is statistically insignificant. No significant fetomaternal complications were seen in both groups.

CONCLUSION:

The efficacy of sublingual misoprostol in the dosage of 50 microg was comparable to 100 microg oral dose for the induction of labour in the primigravidas at term with pre-labour rupture of membranes.

• Authors: Humaira Zaman Malik, Nuzhat Parveen Khawaja, Bushra Zahid, Rakhshanda Rehman
• Journal: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP (J Coll Physicians Surg Pak) Vol. 20 Issue 4 Pg. 242-5 (Apr 2010) ISSN: 1022-386X [Print] Pakistan
• PMID: 20392399 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Oxytocics
• Misoprostol

Topics

• Administration, Oral
• Administration, Sublingual
• Apgar Score
• Female
• Fetal Membranes, Premature Rupture
• Humans
• Labor, Induced (methods)
• Misoprostol (administration & dosage)
• Oxytocics (administration & dosage)
• Pregnancy