Comparision between Intravaginal Misoprostol and Prostaglandin E2 for Labour Induction

OBJECTIVE: To evaluate the use of misoprostol compared with PGE2 for labour induction at term in terms of cesarean delivery, induction delivery interval, hyperstimulation and neonatal outcome. STUDY DESIGN: Comparative descriptive study SETTING: Department of obstetric and Gynecology unit-I labour ward of Liaquat University Hospital Hyderabad (LUH). DURATION: From 13thAugust 2007 to 12th August 2008 PATIENTS AND METHODS: 100 women between the ages of 20 to 29 years, with term gestation of 37 to 42 weeks, having singleton pregnancy with vertex presentation and bishop score of <6 were selected by Convenient Sampling technique. Women with previous caesarean section, fetal distress, para 5 or more, allergy to prostaglandin, uterine anomaly, cardiac disease, acute asthma or glaucoma were excluded. All information was recorded on preformed proforma and analyzed on SPSS version 11.P value <0.05 was taken as significant . Student T test and Chi square test was used, where appropriate to calculate the P value. RESULTS: Total 100 patients were included in the study. Patients were divided into 2 groups.50 Patients in group A received induction with PGE2 and 50 patients in group B received induction with PGE1. Induction was succeeded in 50% patients who received induction with prostaglandin E2 (In group A) and 74% patient’s who received induction with prostaglandin E1 (In group B). 25 (50%) patient’s of group A and 37 (74%) patient’s of group B delivered by spontaneous vaginal delivery while 25 (50%) patient’s of group A and 13 (26%) patient’s of group B requires cesarean section. Results showed that prostaglandin E1 is more effective for induction of labour than PGE2 (P<0.004), however there is risk of hyperstimulation and post partum hemorrhage, which need careful monitoring of patient. CONCLUSION: Prostaglandin E1 (Misoprostol) is more effective and safe for induction of labour than PGE2.However the more frequent occurrence of hyperstimulation needs careful monitoring .Due to its high success rate it has reduce the Caesarean section rate and neonatal ICU admission.