Comparison of vaginal misoprostol and oral misoprostol with intracervical dinoprostone gel for labor induction at term

OBJECTIVE(S) : To compare the efficacy and safety of vaginal misoprostol and oral misoprostol with intracervical dinoprostone gel for labor induction at term. METHOD(S) : In our tertiary referral hospital, 25 mg vaginal misoprostol 6 hourly for a maximum of five doses and 50 mu g oral misoprostol 6 hourly for a maximum of five doses were compared with 0.5mg intracervical dinoprostone gel 12 hourly for a maximum of three doses for induction of labor at term in 150 women in three groups of 50 each. Number of vaginal deliveries achieved, induction to vaginal delivery interval, requirement of oxytocin, incidence of cesarean section for fetal distress, failed induction, side effects, and neonatal outcome were compared. RESULTS : There were no differences in the mode of delivery. Induction to vaginal delivery interval was significantly shorter and lesser number of women required oxytocin in the vaginal misoprostol group compared to intracervical dinoprostone gel group whereas the differences were not significant in the oral misoprostol group. There were no differences in the incidences of cesarean section for fetal distress, failed induction, hyperstimulation, and neonatal outcome. CONCLUSION(S) : Vaginal misoprostol is more effective and as safe, and oral misoprostol is as effective and safe as intracervical dinoprostone gel for labor induction at term, in primigravidas and multigravidas with unfavorable cervices without previous uterine scar.