A randomised comparison of oral misoprostol and vaginal prostaglandin E2 tablets in labour induction at term

Ashalatha Shetty, I. Livingstone, P. Rice, S. Acharya, P. Danielian, Alexander Allan Templeton

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Objective: To compare the efficacy of 100 mug of oral misoprostol with 3 mg prostaglandin E-2 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 mug of misoprostol orally (which could be repeated 4 hourly to a maximum of five doses if indicated), or a 3 mg tablet of prostaglandin E-2 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 PGE(2) group. Of these, 50.7% in the misoprostol group and 54.8% in the PGE(2) 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 mug) has similar efficacy to vaginal PGE(2) tablets, and may be an option to consider for term labour induction.

Original languageEnglish
Pages (from-to)436-440
Number of pages4
JournalBJOG-An International Journal of Obstetrics and Gynaecology
Issue number5
Publication statusPublished - 2004


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