A comparative study of 25µg versus 50µg vaginal misoprostol for induction of labour at term premature rupture of membrane

Abstract

Background: At term, infection remains the most serious complication associated with PROM for the mother and the neonate Induction of labour significantly reduces the risk of maternal and foetal infection. This randomized comparative study has been done to compare the effectiveness and safety of low and high dosage (25 mcg and 50mcg) regimen of vaginal misoprostol for induction in term PROM patients.Methods: At term, infection remains the most serious complication associated with PROM for the mother and the neonate Induction of labour significantly reduces the risk of maternal and foetal infection. This randomized comparative study has been done to compare the effectiveness and safety of low and high dosage (25 mcg and 50mcg) regimen of vaginal misoprostol for induction in term PROM patients.Results: PROM to delivery interval was significantly shorter with 50mcg vaginal misoprostol as compared to 25 mcg vaginal misoprostol (15.71±3.29 hours vs. 18.23±3.23 hours, (p value = 0.0023) Number of doses required was less with 50mcg vaginal misoprostol group as compared to 25mcg vaginal misoprostol (1.22±0.42 vs. 1.91±0.80, p value <0.05). 83.6% women in group A and 69.09% women in group B underwent spontaneous vaginal delivery within 24 hours. 3.64% women in group A and 7.27% in group B had instrumental delivery. Caesarean section was performed in 12.27% cases in group A and 23.64% cases in group B. The complication rate was comparable.Conclusions: 50mcg vaginal misoprostol is more effective and safe for induction of labour at term PROM as compared to 25 mcg vaginal misoprostol