Comparative Study of Intracervical Dinoprostone Gel Versusvaginal Misoprostol for Cervical Ripening and Induction of Labour

Background and objective: The induction of labour is nonspontaneous initiation of uterine contractions before their spontaneous onset leading to progressive effacement and dilatation of cervix and delivery of the baby. Overall rate of induction of labour has increased over last decade. PGE2 has been used for more than a decade for cervical ripening and induction of labour. its been evidenced in literature that misoprostol a PGE1 analogue is extensively evaluated for cervical ripening and induction of labour. We aim to compare between the efficacy of intracervical dinoprostone gel versus vaginal misoprostol tablets for the cervical ripening and induction of labour. Method: This was a prospective study. 100 women which were admitted and who fulfilled the criteria, 100 cases were randomized equally in two groups, 50 patients underwent induction with dinoprostone gel 0.5mg intracevically every 6 hourly till maximum 3 doses and in another group of 50 pts , labour was induced by 25 mcg of misoprostol in posterior fornix of vagina every 4 hourly for maximum 5 doses. Result: In 72% pts in misoprostol group the Bishop score was 2-3,in 90% of pts 25-75mcg of misoprostol was required for successful induction of labour when compared to 66% of cases in dinoprostone group by single application. Induction delivery interval was between 5-18 hours in 84% of cases in the misoprostol group , whereas in only 68% cases , in dinoprostone group induction delivery interval was 7-18 hours . Incidence of LSCS was also less around 6% In misoprostol group when compared to 16% in dinoprostonegroup, cost of misoprostol is cheaper 70/- when compared to 250/-in dinoprostone group. Meconium staining of liquor was found to 8% with misoprostol and 4% in with dinoprostone group