Abstract

Objective: To compare the efficacy of vaginal dinoproston versus misoprostol for induction of labor in women presented with premature rupture of membrane.

Study Design: Randomized controlled trial

Place & duration: Study was done at Department of Gyn & Obs HBS Medical College and Hospital, Islamabad for one year duration from 1st September, 2019 to 31st August, 2020.

Methods: Total 160 pregnant women presented with PROM having gestational age >37 weeks were included. Patients ages were ranging from 18 to 40 years. After written consent detailed demographics including age, BMI, parity were recorded. All the patients were equally divided into two groups. Each group consists of 80 patients. Group M received 25ug misoprostol vaginally while group D received 3mg of dinoprostone gel in the posterior vaginal fornix. Time duration from induction to delivery and mode of deliver were examined, fetal outcomes such as Apgar score at 5 minutes, NICU admission and birth asphyxia were also examined and compare between both groups. Data was analyzed by SPSS 24.0.

Results: No significant difference was observed regarding age, gestational age, parity, and BMI between both groups with p-value >0.05. A significant difference was found regarding time to active labor between both groups M and D 5.72±2.16 hours Vs 7.29±3.48 hours) p-value <0.05. In group M induction to delivery interval was significantly shorter as compared to group D (9.28±2.67 hours Vs 12.46±4.55 hours) p-value <0.05, no significant difference was observed regarding mode of delivery, maconium stained liquor, postpartum hemorrhage, Apgar score at 5 minutes and NICU admission with p-value >0.05.

Conclusion: Vaginal misoprostol is safe and effective for induction of labor in women with premature rupture of membrane at term.

Keywords: Labor induction, Misoprostol, Dinoprostone, Vaginal Delivery, C-section, Apgar score, NICU admission.