A Comparative Study between Sublingual Misoprostol (PGE1) versus Intracervical Dinoprostone Gel (PGE2) in the Induction of Labor:- A Prospective Observational Study

Objective: To compare the efficacy of sublingual misoprostol tablet and intracervical dinoprostone gel for induction of labor and also to assess the maternal and fetal outcome after induction. Methodology: A prospective observational study was conducted over a period of 6 months. Of 200 cases, 100 received sublingual misoprostol tablet (Group 1) and remaining received intracervical dinoprostone gel (Group 2). The time required from induction to delivery interval (IDI), and maternal and fetal outcome were assessed by the mode of delivery, Apgar score, and need for neonatal intensive care unit (NICU) admission. Data were analyzed using descriptive statistics, Student's t-test, and Chi-square test. Results: Induction to delivery time was 14.1 h in Group 1, whereas 13.9 h in Group 2. Stage II of labor was 2.3 h and 3.1 h in Group 1 and 2 (P < 0.05) respectively. Normal vaginal delivery occurred in 66 cases in Group 1 and 56 cases in Group 2. Apgar score (>= 7) at 1 min was observed in 91 and 93 cases of Group 1and Group 2, respectively. Augmentation of labor by artificial rupture of the membrane was needed in 17 cases in Group 1 and 39 cases in Group 2 (P < 0.05). The need of NICU admission was 20 in Group 1 and 19 in Group 2 (P < 0.05). Conclusion: The misoprostol group showed shorter IDI, more number of vaginal deliveries, and reduced need of cesarean section, compared to dinoprostone group. There was a significant difference in the post induction Bishop's score, Stage II process of labor and reduction in the requirement of augmentation (ARM) between the two groups. Misoprostol was found to be more efficacious when compared to dinoprostone.