A COMPARATIVE STUDY OF 25 MICROGRAMS VERSUS 50 MICROGRAMS OF INTRAVAGINAL MISOPROSTOL FOR CERVICAL RIPENING AND INDUCTION OF LABOUR (IOL)

Abstract

Background- Misoprostol is a safe drug and increasing the dose needed to be tried for decreasing Induction- delivery- interval (IDI). ObjectivesTo compare 25µG versus 50µG of intravaginal Misoprostol for cervical ripening and induction of labor (IOL). Methods- A prospective observational comparative study was done in the Department of Obstetrics & Gynecology of a tertiary institute of northern India from January 2018 to June 2019. One hundred pregnant women with Bishop's Score <6 for induction of labour were randomized : Group A (50 Odd No.) Tab.25µG Misoprostol pervaginum and Group B ( 50 Even No.) Tab.50µG Misoprostol pervaginum. In both groups, a thorough history, physical and obstetrical examination including Bishop's score was done. The same dose was repeated 4 hourly with monitoring the progress of labor and FHS. Number of doses required, induction-delivery- interval, need for oxytocin augmentation, mode of delivery, complications and fetal outcome were recorded. Statistical Analysis: by using chi-square, one sample t-test between percents, and McNemar test on Epi Info 7.2.31.Results- Both groups were comparable for all the outcome variables. (P>0.05.) However signicantly greater number of women delivered with only one dose of 50µG versus 25µG i.e., 40% versus 20% (P=0.008). Also, more women delivered in <12 hours with 50µG (41.86%) than 25µG (22.73%) Misoprostol pervaginum (P=0.016). Furthermore, more women delivered in <12 hours and with only a single dose of 50µG (41.86%) than 25µG(22.73%) Misoprostol pervaginum (P=0.016). Conclusions- 50µG is more effective than 25µG Misoprostol pervaginum in all women for induction of labor especially signicantly more where delivery needs to be expedited like HDPas signicantly more women delivered in <12 hours (P=0.016)with single dose only(P=0.008).