Comparison of Safety, Efficacy and Cost Effectiveness of Intravaginal Misoprostol and Intracervical Dinoprostone for Induction of Labour

International Journal of Pharmacology and Clinical Sciences, 2014, 3, 3, 68-72.
Published: September 2014
Type: Research Article
Authors: Dara Aruna Kumari, and Gujjala Radhika

Author(s) affiliations:
Dara Aruna Kumari^1*, Gujjala Radhika^2
1Asst. Professor, Dept. of Pharmacology, ²Asst. Professor, Dept. of Physiology , Government Medical College, Ananthapuramu, Andhra Pradesh – 515001, India.

Abstract

Background: Misoprostol is more efficacious than dinoprostone for induction of labour. But the adverse effects pro-duced by misoprostol were different. The aims of this study was to compare the safety, efficacy, cost effectiveness of intravaginal misoprostol and intracervical dinoprostone for induction of labour and their effects on intrapartum complications, mode of delivery and neonatal outcome. Materials and Methods: This is a randomized, parallel, two tailed, prospective, open label comparative trial. Sixty pregnant women were included in the study and it was carried out in the Department of Obstetrics, Government General Hospital, Kurnool Medical College, Kurnool during the period Dec. 2009 – June 2010. Out of 60 patients, 30 received miso-prostol 25 mcg intravaginally and 30 received dinoprostone 0.5 mg intracervically. Analysis and comparison of various parameters like induction- delivery interval, mode of delivery, neonatal outcome, foeto-maternal complications and cost of the drug were done. Mean and standard deviation of all observations were calculated and tabulated with the help of ‘Microsoft Excel’. Comparison was done by applying student’s t -test. Statistical significance was assigned at P<0.05. Results: Misoprostol is more efficacious for cervical ripening and labor induction than dinoprostone. Misoprostol group had more number of vaginal deliveries, lesser requirement of oxytocin for labor augmentation, more number of vaginal deliveries within 12 hrs, less induction failures and was cost effective. However, it was reported to have slightly higher incidence of uterine contractility abnormalities and foetal complications. Conclusion: Misoprostol is more efficacious than dinoprostone. However uterine contraction abnormalities, fetal com-plications should be carefully assessed by close monitoring of labor by intrapartum cardiotocography and partogram.

Keywords: Cervical ripening, Induction – delivery interval, Induction failure, Labor induction, Tachysystole