Comparative Study to Evaluate the Efficacy and Safety of 25 Microgram Misoprostol for Induction of Labour With Sublingual Versus Vaginal Route

Introduction When the risk of continuation of pregnancy is more either to the mother or to the foetus, induction is indicated Timely induction can reduce maternal morbidity and mortality as well as assure the delivery of healthy baby .Sublingual misoprost is another route of administration that can be compared with vaginal administration as both require mucosal uptake of drug. Since pharmacokinetics is different for sublingual and vaginal misoprost, difference in efcacy and side effects needs to be compared. Materials and Methods This was a prospective parallel randomized controlled trial study conducted on 350 women who were admitted at dept of obstetrics and gynaecology, fortis escorts hospital and research centre Faridabad from june 2016 to june 2018 The subjects were categorized into two groups(sublingual and vaginal) of 175 patients in each group. The present study compares the efcacy of sublingual versus per vaginal route of Misoprostol administration in pregnant females at term in terms of successful vaginal delivery, induction delivery time interval, number of doses of Misoprostol required, need for oxytocin augmentation, side effects and foetal outcome measures such as APGAR score at birth, and admission to NICU. Mean dose required for sublingual group was 72.43±21.79 mcg and for vaginal grou Results and Discussion p was 78.43±23.73 p value was 0.002 which is statistically signicant. Mean induction delivery interval was 12.11±3.87hrs in sublingual group while it was 20.1±1.5 hrs in vaginal group p value was 0.003 which is statistically signicant. GI side effects were more in sublingual group Hyperpyrexia was almost similar in both groups Hypertonic uterine contractions were also similar in both groups. Foetal distress occured more in sublingual group. Cervical tear and vaginal lacerations were seen more in vaginal group. Irrespe Conclusion ctive of various labour induction methods induction of labour with misoprostol is safe, efcacious and clinically acceptable. Sublingual misoprostol has better efcacy in terms of no of doses required and induction delivery interval. On the other hand side effects are less seen with vaginal route. Both groups are not associated with any signicant Neonatal adverse outcome and both groups were equally efcacious in achieving successful vaginal delivery