Role of titrated low dose oral misoprostol solution in induction of labour

Background: Oxytocin is a time tested drug used for induction of labour. However, certain disadvantages associated with oxytocin can be countered if misoprostol is used for the same purpose. But excessive uterine contractility has been a cause of concern with misoprostol use. Based on pharmacological profile of misoprostol, this study was carried out using oral misoprostol solution for induction of labour in low dose, titrated according to uterine contractions and the outcomes were compared with oxytocin.Methods: A total of 157 women fulfilling inclusion and exclusion criteria were enrolled in the study and cervical ripening was carried out. After the cervix became favorable (Bishop Score >6), a total of 54 women received titrated oral low dose misoprostol (group 1), and 52 received intravenous oxytocin (group 2). Both the drugs were compared in terms of labour outcomes, efficacy, adverse effects and neonatal outcomes.Results: There was no significant difference in the mean induction to onset of labour interval and mean induction to delivery interval in group 1 and group 2. Also, there was no significant difference in the modes of delivery and adverse effects and neonatal outcomes in both the groups, except group 1 had a significantly lower incidence of neonates with Apgar score <7 at 5 min.Conclusions: For induction of labour in women with term gestation after cervical priming, low dose oral misoprostol solution in titrated doses and intravenous oxytocin were found to be comparable with each other in terms of labour outcomes, efficacy and adverse effects