A comparison between intravaginal and oral misoprostol for labor induction: A randomized controlled trial

Aim: To compare the effectiveness and safety between intravaginal and oral misoprostol for labor induction. Methods: One hundred and six pregnant women at term with unfavorable cervix (Bishop score less than or equal to 4) and no contraindication to prostaglandin therapy were randomized to receive either intravaginal misoprostol 50 mug every 4 h or oral misoprostol 50 mug every 4 h for prospective randomized controlled trial study. Treatment interval from induction to vaginal delivery, maternal and neonatal complications were the main outcome measures. Results: There were no statistical differences of baseline characteristics and Bishop score prior to intervention between both groups. Time interval from induction to vaginal delivery in the oral group was slightly, but significantly, longer than that of the intravaginal group (886.1 +/- 443.5 min vs 637.0 +/- 373.3 min, respectively.) Additionally, the number of doses required was significantly higher in the oral group. Nonetheless, there was no significant difference between both groups with regard to failure of induction and maternal-neonatal complications. Conclusion: The effectiveness in terms of failed induction and safety were comparable between intravaginal and oral misoprostol, but intravaginal route was better with respect to treatment interval and number of required doses. Both routes of administration can alternatively be used for labor induction.