Sublingual versus oral misoprostol for induction of labour in prelabour rupture of membranes at term

J Coll Physicians Surg Pak. 2010 Apr;20(4):242-5.

Abstract

Objective: To compare the efficacy of sublingual with oral misoprostol for induction of labour in primigravida with prelabour rupture of membranes at term.

Study design: Randomized controlled trial.

Place and duration of study: Department of Obstetrics and Gynaecology Unit-II, Sir Ganga Ram Hospital, Lahore, from June 2004 to January 2006.

Methodology: The study included 100 primigravidas with singleton pregnancy at term, having pre-labour rupture of membranes and unfavourable Bishop score with no contraindication of induction of labour, vaginal delivery or misoprostol use. The cases were randomized into two equal groups, A and B. Women in the group A were given 100 microg of misoprostol orally at an interval of 4 hours to a maximum of 2 doses while patients in the group B were prescribed the medicine sublingually (50 microg, 4 hourly, maximum of 2 doses). Induction to delivery interval, mode of delivery and fetomaternal complications were main outcome measures of the study.

Results: In the sublingual misoprostol group (B), 92% women delivered within 12 hours of induction while 84% of subjects delivered in this time period in oral group (A, p < 0.05). There was no failed induction in either group. Regarding dosage, 64% of women delivered with single dose in group B while only 32% delivered with single dose in group A (p < 0.05). The frequency of vaginal delivery was 92% in group B versus 80% in group A, while rate of caesarean section was 8% in the group B and 20% in the group A, which is statistically insignificant. No significant fetomaternal complications were seen in both groups.

Conclusion: The efficacy of sublingual misoprostol in the dosage of 50 microg was comparable to 100 microg oral dose for the induction of labour in the primigravidas at term with pre-labour rupture of membranes.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Administration, Sublingual
  • Apgar Score
  • Female
  • Fetal Membranes, Premature Rupture*
  • Humans
  • Labor, Induced / methods*
  • Misoprostol / administration & dosage*
  • Oxytocics / administration & dosage*
  • Pregnancy

Substances

  • Oxytocics
  • Misoprostol