Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 14 , ISSUE 6 ( November-December, 2022 ) > List of Articles


Induction of Labor with Oral Misoprostol vs Oxytocin: A Comparative Study

Tanya Das, Meena Thapa

Keywords : Induction, Labor, Maternal and perinatal outcome, Misoprostol, Obstetric outcome

Citation Information : Das T, Thapa M. Induction of Labor with Oral Misoprostol vs Oxytocin: A Comparative Study. J South Asian Feder Obs Gynae 2022; 14 (6):710-713.

DOI: 10.5005/jp-journals-10006-2147

License: CC BY-NC 4.0

Published Online: 31-01-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Objective: To compare the effectiveness of oral misoprostol versus intravenous oxytocin for induction of labor. Methodology: This was a single-center, prospective comparative study done at a tertiary care academic health center from January 2018 to June 2019, where a total of 266 term pregnant women who were candidates for induction of labor were assessed and selected to enter the study. The women were assigned to one of the two groups according to the mode of induction, oral misoprostol, or intravenous oxytocin. The misoprostol group received 25 μg of oral misoprostol solution every 2 hours for a maximum of six doses, and the oxytocin group received an infusion drip starting from 6 mIU/minute, which gradually increased every 30 minutes up to a maximum of 37 mIU/minute. Women who went into active labor within 24 hours of the first dose in the misoprostol group and 12 hours in the oxytocin group were considered successful induction. Results: The successful induction rate was more with oral misoprostol than with oxytocin (64.3% vs 58.8%). More women delivered vaginally with oral misoprostol as compared to oxytocin (59.1% vs 50.4%). Induction to active labor time and induction to delivery time was significantly shorter for the oxytocin group than the misoprostol group (5.96 ± 2.59 and 7.75 ± 2.90 vs 10.15 ± 5.66 and 12.53 ± 6.33 hours; p-value <0.001). Conclusion: Oral misoprostol is a safe and effective drug with low complications for induction of labor in women with an unfavorable cervix compared to oxytocin.

PDF Share
  1. World Health Organization. WHO recommendations for induction of labour. World Health Organization; 2011.
  2. Acharya T, Devkota R, Bhattarai B, et al. Outcome of misoprostol and oxytocin in induction of labour. SAGE Open Med 2017;5. DOI: 10.1177/2050312117700809.
  3. Komala K, Reddy M, Iqbal Jehan Quadri SB, et al. Comparative study of oral and vaginal misoprostol for induction of labour, maternal and foetal outcome. J Clin Diagn Res 2013;7(12):2866–2869. DOI: 10.7860/JCDR/2013/5825.3779.
  4. Morris JL, Winikoff B, Dabash R, et al. FIGO's updated recommendations for misoprostol used alone in gynecology and obstetrics. Int J Gynecol Obstet 2017;138(3):363–366. DOI: 10.1002/ijgo.12181.
  5. The Federation of Obstetric and Gynaecological Societies of India. Induction of Labor: Good Clinical Practice Recommendations. Mumbai. FOGSI-ICOG; 2018:16–38.
  6. Alfirevic Z, Weeks A. Oral misoprostol for induction of labour. Cochrane Database Syst Rev 2006.
  7. Alfirevic Z, Aflaifel N, Weeks A. Oral misoprostol for induction of labour. Cochrane Database Syst Rev 2014;6:CD001338. Art. no.: CD001338
  8. Hanley GE, Munro S, Greyson D, et al. Diagnosing onset of labor: A systematic review of definitions in the research literature. BMC Pregnancy Childbirth 2016;16(1):71. DOI: 10.1186/s12884-016-0857-4.
  9. American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 107: Induction of labor. Obstet Gynecol 2009;114(2 Pt 1): 386–397. DOI: 10.1097/AOG.0b013e3181b48ef5.
  10. Aalami-Harandi R, Karamali M, Moeini A. Induction of labor with titrated oral misoprostol solution versus oxytocin in term pregnancy: Randomized controlled trial. Rev Bras Ginecol Obstet 2013;35(2):60–65. DOI: 10.1590/s0100-72032013000200004.
  11. Asokan KM, Santhosh S. Comparative study of titrated oral misoprostol solution and oxytocin to induce labor conducted at Kannur Medical College. Int J Sci Study 2016;3(1):255–258. DOI: 10.17354/ijss/2016/96.
  12. Rouzi AA, Alsahly N, Alamoudi R, et al. Randomized clinical trial between hourly titrated and 2 hourly static oral misoprostol solution for induction of labor. Am J Obstet Gynecol 2017;216(4):405.e1–405.e6. DOI: 10.1016/j.ajog.2016.11.1054.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.