Induction of Labor Using One Dose versus Multiple Doses of Misoprostol: RCT

Document Type : Original Article

Authors

The Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University* and Aswan Insurance Hospital

Abstract

Abstract Background: Situations arise in obstetrics where it becomes necessary to end a pregnancy in the interest of the mother or baby or both. There is a growing interest in the use of miso-prostol, a prostaglandin E1 analogue for labour induction. Induction of labour is a common obstetric intervention and the use of misoprostol as an induction agent is important due to its low cost and stability at room temperature. These additional advantages make it a suitable agent, particularly in under-resourced settings and tropical countries. Aim of Study: This study was conducted to compare the rate of vaginal delivery within 24 hour among patients who undergo induction of labor between those who receive vaginal single dose of misoprostol with those receive up to 5 doses of this medication. Patients and Methods: The study was a randomized controlled open labeled clinical trial, study setting was Ob-stetrics and Gynecology Department of Ain Shams Maternity University Hospital (Emergency Department), the study timing was 6 months from March to September 2019, this study was conducted on 206 women who came to Emergency Department of Obstetrics and Gynecology Department of Ain Shams Maternity University Hospital. Results: The majority (70.87%) had V D in 24 hours in one dose group versus 75.73% in multiple doses without significant difference between both groups. Time from induc-tion to delivery in one dose group ranged from 10-32 with mean value of 17.990±5.579 while in multi-dose group was 10-33 (with mean value 18.204±5.206) without significant difference between groups. Latent period in one dose group ranged from 3-11 with mean value of 5.918±2.077 while in multi-dose group was 3-12 (with mean value 6.500±2.173) without significant difference between groups. There was non-significant difference between one dose and multiple doses in incidence of fetal distress as the majority in one dose group 92.23% than 90.29% in muti-dose group. Conclusion: The single-dose misoprostol appears to be an acceptable alternative to a multiple dose regimen for cervical ripening before the induction of labor. Our data indicates that there was no difference regarding the clinical efficacy between two labour induction regimens of vaginal misoprostol.

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