Abstract

Background: Cervical ripening isanimportant prerequisite for successful induction of labor,a procedurethat is frequently necessary because of medical or obstetrical complications. Of several methods of ripening, intracervical dinoprostone gel and intravaginal misoprostol tablet are the most frequently used methods. Aims andObjectives: To compare the efficacy and safety of intracervical dinoprostone gel and intravaginal misoprostol tablet as a cervical ripening agent. Materials andMethods: A total of 138 pregnant women satisfying the inclusion criteria were studied. They were divided intotwogroups:72ingroup1(dinoprostonegel)and66ingroup2(misoprostoltablet).Thesafetyandefficacyofboththe drugswereanalyzed.TheprimaryoutcomevariableswerechangeinBishop’sscore,inductiontodelivery(I-D)time,Apgar score, and incidence of abnormal uterine action. The secondary outcome variables were need for oxytocin, indication for 2 caesarean section, and mode of delivery. Statistical analysis was done using the unpaired t-test and w -test.
Results: No difference was observed between the two groups with respect to change in Bishop’s score (3.015 vs 3.625, p4 0.05), but I-D time was more for group 1 (i.e., 15.04 vs 11.48 h, po 0.05). Apgar scores were also similar in both the groups, that is, the number of babies with Apgar score ofo8 at 5 min was 3 for group 1 vs 6 for group 2, p 4 0.05. Abnormal uterine action was not seen at all in group 1, whereas three patients had this problem in group 2. In secondary variables, requirement of oxytocin was more in group 1 (i.e., 48 vs 22, po 0.05). In various indications of caesarean section, none got operated for abnormal uterine action in group 1, whereas three patients got operated for this reason in group 2. Mode of delivery was similar in both the groups.
Conclusions: Dinoprostone and misoprostol are similar in their action on cervical ripening. Misoprostol has an added benefitofbeingauterotonicagent.Therefore,ithaslessI-Dtime.Low-doseofmisoprostolhasdecreasedtheincidenceof side effects.