A Comparative Study of 25 mcg vs 50 mcg of Vaginal Misoprostol for Induction of Labor

Objectives: To compare the efficacy and safety of 25 mcg intravaginal misoprostol vs 50 mcg misoprostol for induction of labor. Material and methods: This study group consisted of 100 cases of low-risk singleton pregnancies attending the antenatal clinic of SAH and RC, or admitted to the antenatal ward. Study group included singleton pregnancy, Over 37 weeks of gestation with Vertex presentation, with unfavorable cervix (bishop score <4) and patients not in labor with reactive fetal heart rate pattern with intact membranes. Women were randomized to either 25 mcg (n = 50) or 50 mcg (n = 50) of intravaginal misoprostol. The dose was repeated every 4 hours (maximum number of doses limited to 3 doses). The main outcome was induction vaginal delivery interval. Results: Induction delivery interval was significantly less with 50 mcg misoprostol –9.45 hours in comparison to 25 mcg 14.2 hours (p-value <0.001), most cases delivered vaginally with 25 mcg misoprostol p value < 0.013, cesarean section rates were high in 50 mcg misoprostol group p-value <0.007, the proportion of women delivering vaginally with single dose of vaginal misoprostol was high in 50 mcg group, i.e. 64%, incidence of maternal complications like tachysystole and hyperstimulation was more with 50 mcg group. Conclusion: In the present study, it is concluded that 25 mcg of misoprostol is safe and effective for labor induction.