Oral Versus Vaginal Administration of Misoprostol, for induction of Labor, in Women Presenting with premature Rupture of Membranes.” 1 year Randomized Controlled Trial at KAHER’S Dr. Prabhakar Kore Charitable Hospital, Belagavi

Abstract

INTRODUCTION: In patients presenting with Pre Labor Rupture of Membranes, Iduction of labour or augmentation of labor is preferred over expectant management, to reduce the duration of labor and to reduce the chances of complications like chorioamnionitis, neonatal infections, etc. Misoprostol has been recommended by the WHO for the purpose of IOL.5 OBJECTIVE: To compare the effectiveness of orally administered misoprostol, with vaginally administered misoprostol, for IOL in women with PROM. The mean interval between induction and active labor (cervical dilatation ≥4cm) and induction to delivery interval were compared between the two groups. STUDY DESIGN: 1 year Randomized Controlled Trial SOURCE OF DATA: All women presenting with PROM to the labor room of KAHER’S Dr. Prabhakar Kore Charitable Hospital, Belagavi. STUDY PERIOD: 1 year (January 2018- December 2018) METHOD: All women presenting with PROM, fitting the inclusion criteria, were enrolled after taking written informed consent and randomized. Each subject received 25 mcg of misoprostol 2nd hourly, orally or 25mcg misoprostol vaginally, 3rd hourly, for induction of labor. The time taken by each group to reach active labor (cervical dilatation ≥4cm) was compared. RESULTS: The interval between the induction and active labour was found to be significantly shorter (4.7±2.1hours) as compared to the vaginal group (10.1±4.5hours). The interval between induction to delivery was also found to be significantly shorter in the oral group (8.9±3.5hours) as compared with that in the vaginal group (14.1±4.4hours), with similar rates of side effects in both the routes. CONCLUSION: Oral misoprostol is a simpler, effective and more convenient route of administration as compared to the vaginal route for induction of labor in PROM.