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.
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