A comparison of oral Misoprostol and intravaginal Dinoprostone for induction of labour: A Retrospective observational study

Bakr Khader Abo Jarad, Malak Alshaikhali, Mohammed Elbelbessi, Bettina Böttcher

Abstract


Objective: To compare the efficiency, safety and cost of 50 mcg oral Misoprostol with intravaginal Dinoprostone for labour induction in women with singleton pregnancy.

Methods: This is a retrospective study of induced deliveries using 50 mcg oral Misoprostol repeated every six hours or 3 mg vaginal Dinoprostone repeated every eight hours. The primary outcome was delivery within 24 hours and total time from starting induction to delivery and the secondary outcomes mode of delivery as well as maternal and fetal outcomes.

 Result: In total, 280 woman were included: 140 (50%) received vaginal Dinoprostone and 140 (50%) received oral Misoprostol. Women who received Misoprostol had a lower rate of caesarean delivery (9.3% vs 18.5%, P=0.001) and lower risk of fetal distress (3.6% vs 12.8%, P=0.032). The percentage of deliveries within 24 hours was similar in both groups.

Conclusion: Women induced with oral Misoprostol experienced less frequent failure of induction, significantly shorter duration until delivery and higher normal delivery rates than those induced with vaginal Dinoprostone. Furthermore, oral Misoprostol was significantly less expensive when compared to vaginal Dinoprostone. This suggests that oral Misoprostol could be a more cost effective alternative to Dinoprostone for induction of labour in low resource countries.


Keywords


Induction of labour, Misoprostol, Dinoprostone, Gaza-Strip, Palestine, cost-effectiveness

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