Titrated Oral Misoprostol Compared to Vaginal Dinoprostone for induction of labor: A Randomized controlled trial

Abstract

is now generally accepted that the uterine cervix plays an important role during pregnancy and labor and that it depends on an active ripening process within the cervix. Which is necessary for successful labor induction. Different methods of cervical ripening have been used including non pharmacological methods as breast stimulation, membrane stripping and amniotomy, pharmacological methods including estradiol, oxytocin, prostaglandins and prostaglandin analogues have been tried. Misoprostol is a synthetic prostaglandin E1 analog and has been reported to be a considerably safe and efficacious cervical ripener. It is inexpensive, easy to administer, stable at room temperature, does not require refrigeration. In spite of different doses and routes of administration (sublingual, oral, vaginal), ideal dosage and mode of administration remain to be controversial. Potential complications such as uterine rupture, tachysystole and uterine hyperstimulation should be emphasized with respect to adverse maternal and neonatal outcome. A considerable amount of work has concentrated on optimum dosing regimen that minimizes the risk while maintaining efficacy since both efficacy and side effects are suggested to be dose dependent.