The effect of vaginal Misoprostol and intravenous Oxytocin for labor induction

Background: Unripe cervix is one of the most causes of failure of labor induction. There are different methods for labor induction, which may differ depending on its duration. This study was performed to compare the effectiveness of vaginal Misoprostol intravenous and Oxytocin for induction of labor on hospitalized patients.

Methods: In a randomized clinical trail 110 pregnant women with Bishop score<6 requiring induction of labor were divided into two groups.  The first group (n=50) received 25 mg vaginal Misoprostol and dosage was repeated every 4 hours until reach to either onset of the active labor or the final dose of 100 mg.  Second group (n=60) received intravenous Oxytocin started from 2.66 mu/min and up to the maximum dose of 42.5 mu/min or until the onset of the active labor. Inductions to delivery time interval, maternal and neonatal outcomes were recorded.  Statistical analysis was performed using the U Mann-Whitney and Chi Squared tests.

Results:  After matching mother age, gestational age, Bishop score, gravidity and parity, sample size decreases to 48 cases in Misoprostol group and 54 cases in Oxytocin group.  There was no significant difference in the mean time from induction to delivery between Misoprostol and Oxytocin groups (10.16+3.66 vs. 8.86+3.65 and P=0.121). The rate of cesarean was 18.8% and 25.9% in Misoprostal and Oxytocin groups, respectively (P=0.387). This study showed that the maternal and neonatal outcomes of induction were not significantly different in two groups.

Conclusion: It seems that vaginal Misoprostol could be administrated for the induction of labor.