A randomised comparison of oral misoprostol and vaginal prostaglandin E₂tablets in labour induction at term

Shetty, A., Livingstone, I., Acharya, S. , Rice, P., Danielian, P. and Templeton, A. (2004) A randomised comparison of oral misoprostol and vaginal prostaglandin E₂tablets in labour induction at term. BJOG: An International Journal of Obstetrics and Gynaecology, 111(5), pp. 436-440. (doi: 10.1111/j.1471-0528.2004.00107.x) (PMID:15104606)

Abstract

Objective:  To compare the efficacy of 100 μg of oral misoprostol with 3 mg prostaglandin E2 vaginal tablets in term labour induction. Design:  A non‐blinded, randomised, controlled trial. Setting:  A tertiary level, teaching Scottish Hospital. Population:  Two hundred women at term with indications for labour induction and modified Bishop's cervical score of less than 8. Methods:  The women were randomly allocated to receive either 100 μg of misoprostol orally (which could be repeated 4 hourly to a maximum of five doses if indicated), or a 3 mg tablet of prostaglandin E2 vaginally (which could be repeated in 6 hours, according to routine departmental protocol). Main outcome measure:  The number delivering vaginally within 24 hours of the induction. Results:  Seventy‐five women delivered vaginally in the misoprostol group and 73 in the PGE2 group. Of these, 50.7% in the misoprostol group and 54.8% in the PGE2 group delivered within 24 hours of the induction (RR 0.92, 95% CI 0.7 to 1.3). More women in the misoprostol group were given oxytocin, but this was not statistically significant (60%vs 47%, RR 1.3, 95% CI 0.98 to 1.7). Two women in the misoprostol group had uterine hyperstimulation. The neonatal outcomes were not significantly different in the two groups. There was a £1100 saving on direct drug costs in the misoprostol group. Conclusions:  Oral misoprostol (100 μg) has similar efficacy to vaginal PGE2 tablets, and may be an option to consider for term labour induction.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Acharya, Santanu
• Authors: Shetty, A., Livingstone, I., Acharya, S., Rice, P., Danielian, P., and Templeton, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: BJOG: An International Journal of Obstetrics and Gynaecology
• Publisher: Wiley
• ISSN: 1470-0328
• ISSN (Online): 1471-0528
• Published Online: 08 March 2004