Misoprostol Versus Dinoprostone for Induction of Labor In Prom: A Randomized Controlled Trial

Abstract

Objectives: To compare the efficacy of misoprostol (PG E₁ analog) and dinoprostone (PGE₂) for induction of labor in prelabor rupture of membranes (PROM).

Study Design: Randomized Controlled Trial.

Patients & Methods: 1^st January 2019 to 30^th June 2019,  Department of Obstetrics & Gynecology, Mardan Medical Complex, Mardan. A total of 214 women (107 in each group) presenting with PROM within 72 hours with gestational age between 34 to 41 weeks having 15-45 years of age were included. Patients with history of failed induction, infusion of oxytocin, oral misoprostol intake, twin pregnancy, cardiac problems and previous CS were excluded. All women were randomly allocated in two groups (A & B) by lottery method. Group A women received 25 mcg of tablet misoprostol and Group B women received 3mg of dinoprostone placed aseptically in the posterior vaginal fornix. Both groups were followed for 24 hours after the first dose for induction to delivery interval. Efficacy was considered when induction to delivery interval was less than 12 hours.

Results: The mean age of women in Group-A was 28.89 ± 4.58 years and in Group-B was 26.64 ± 5.80 years. Majority of patients 153 (71.50%) were between 15 to 30 years. The mean gestational age in group A was 38.86 ± 1.03 weeks and in group B, it was 38.97 ± 1.03 weeks. In group A 60 patients (56.07%) were delivered in less than 12 hours after induction while in group B, only 37 patients (34.58%) were delivered in less than 12 hours with highly significant p-value of 0.02.

Conclusion: This study concluded that misoprostol (PGE₁ analog) is more effective as well as cheaper than dinoprostone (PGE₂₎ for induction of labor among women with prelabor rupture of membranes (PROM). 

Keywords:  Dinoprostone. Misoprostol, Prelabor rupture of membranes, PROM, Prostaglandin E₁ analog, Prostaglandin E₂.