Misoprostol alone versus a combination of dinoprostone and oxytocin for induction labor

OBJECTIVE(S) : To compare the safety, efficacy, cost and fetal outcome of misoprostol with that of combination of dinoprostone and oxytocin for induction of labor. METHOD(S): All eligible women admitted for induction of labor during the period from December 2003 to May 2004 were included in the study (n=72). They were randomized to receive either misoprostol 25 mu g intravaginally every 4 hours for a maximum of 8 doses (study group n=37) or dinoprostone 0.5 mg intracervically 6 hourly for a maximum of 3 doses followed by oxytocin if necessary (control group n=35). RESULTS: Induction delivery interval was significantly shorter in the study group (10.20 +/- 13.50 hours vs 14.27 +/- 5.51 hours; P<0.001). Cesarean section rate in the study group was lower than that in the control group but not significantly so (21.62% vs 37.14%; P>0.05) Failure to progress was the main indication for cesarean section in the control group. Fetal distress was more common in the study group than in the control group but not significantly so. Neonatal outcome was comparable in the two groups. The cost of therapy was significantly less in the study group. (Rs 9/- vs Rs 406.57/- per woman; P<0.001). CONCLUSION(S): Misoprostol alone was more effective and highly inexpensive alternative to the combination of dinoprostone and oxytocin for labor induction.