A Randomized Controlled Trial on the use of Misoprostol in the induction of labour

Abstract

The aun of this study was to evaluate efficacy and safety of misoprostol versus oxytocin in the induction of labour as regards delivery intervals fetal hemi rate changes, mode of delivery and neonatal outcome.

214 patients were assigned by means of a randomized computer number generation to receive misoprostol or oxytocin by the closed envelope method. The inclusion criteria were incluclecl in the study.

Patients receiveclmisoprostol intravaginally in the posterior vaginal fornix, the dosing regimen 50 Jlgms/6 hours till an adequate contraction pattern (three or more contractions in I 0 min.), with amplitude of at least 50 mm Hg and duration of at least 40 seconds for each contraction, cervical ripening (Bishop score > 8 or dilatation> 3 ems.), spontaneous rupture of membranes occurred, or when 24 hours had elapsed or the maximum dose has been given (200 Jlgms)

Artificial rupture of membranes was clone when it was clinically safe, when the cervix became 80% effaced and 3 em dilated or when dilatation was >4 em regardless of effacement. Patients who either did not enter active labour after receiving the maximum dose of 200 Jlg, had spontaneous rupture of the membranes without an ensuring adequate contraction pattern, or who had arrest of dilatation (no change in cervical dilatation for >2 hours at >4 em dilatation) received oxytocin intravenously (5 U/1;2 L glucose 5%). Augmentation was instituted, when deemed necessary, 4 hours after the last misoprostol close.

Oxytocin infusion was initiated at 20 drops/min. of 5 units oxytocin/Y2 L. glucose 5% and was increased every 30 minutes to a maximum of 40 drops/min., to achieve an adequate contraction pattern .