Comparative study of intracervical dinoprostone gel and vaginal misoprostol for induction of labour- one year randomised control trial at tertiary care centre, Belagavi

Abstract

Introduction: Induction of labour is the artificial initiation of labour before its spontaneous onset for the purpose of delivery of the fetoplacental unit using mechanical or pharmacologic methods. There has been a rise in the incidence of labor over the past decades and as per the WHO Global survey, 9.6% deliveries required induction and in developed countries the incidence is up to 25%. This study is an attempt to compare the number of successful induction in dinoprostone and misoprostol group and also to compare the maternal and fetal outcome in both the groups. Material and Methods: Antenatal cases getting admitted to labour room of KLES Dr. Prabhakar Kore Hospital & MRC, Belgavi at term for induction of labor were enrolled for the study. Patients were divided randomly into 2 groups of intracervical dinoprostone (group 1) and vaginal misoprostol (group 2) and then number of successful and failed inductions, indication for the induction, time of initiation to active labour time, induction to delivery, need for augmentation, important outcomes of labour was recorded along with fetal and maternal outcome. Results: A total of 240 cases were included in the study. Majority of the females belonged to the age group of 20-30 yrs in both the groups with mostly multigravida and Mean gestational age around 39± 1.26 wks and 39.12 ± 1.35 wks in group 1 and 2. There were a total of 170 successful inductions and there were 24 failed induction in our study. The major indication for induction in both the groups was PIH followed by decreased fetal movements in both the groups respectively. The mean time to active labour in Dinoprostone group was 8.93 ± 4.42hrs while in other group was 9.71 ± 4.58. The mean time to delivery in the dinoprostone group was 11.72 ± 5.1 hrs while in other group was 12.43 ± 4.58hrs. Need of augmentation, modes of delivery, indications of cesarean section, maternal outcomes and fetal outcomes when compared in both the groups, difference were statistically insignificant. Conclusion: Comparison of dinoprostone and misoprostol with respect to successful induction, maternal and fetal outcome was similar and found to be statistically insignificant. There is a need for further larger studies to establish and document the findings of our study.