A COMPARATIVE STUDY BETWEEN THE USE OF INTRAVAGINAL MISOPROSTOL AND INTRAVENOUS OXYTOCIN FOR INDUCTION OF LABOUR AFTER PRE-LABOR RUPTURE OF MEMBRANES AT TERM

Gona Aziz Rahem a


a Sulaimaniyah Maternity Teaching Hospital, Kurdistan Region, Iraq.


Submitted: 1/1/2019; Accepted: 1/12/2020; Published: 21/12/2020
ABSTRACT


Background 

Misoprostol is a prostaglandin E1 analogue medication, has been shown to be effective and safe for induction of labor in women with pre-labour rupture of membranes at term.


Objective 

The aim of this study is to compare efficacy and acceptability of intravaginal misoprostol with intravenous oxytocin for induction of labor after pre-labour rupture of membranes at term. 


Patients and Methods

This study was conducted as prospective randomized trial at the department of Obstetrics and Gynecology in Maternity teaching hospital and Rizgary hospital in Erbil, performed in 2010-2011. The study involved 100 pregnant women with uncomplicated pregnancies at term, with pre-labour rupture of membranes. The women were assigned to receive 50 Microgram of vaginalmisoprostol every 4 hours (50 patients) or oxytocin infusion (50 patients). The patients were selected randomly from the Labour room. The parameter studied were induction to delivery interval, rate of cesarean section, indications of cesarean section, neonatal outcomes, maternal complications and maternal satisfaction. The test that used for statistical analysis of variables was t-test.


Results

The two groups were comparable with respect to maternal age, gestational age in weeks, parity and Bishop score. The time interval from induction to delivery was shorter in misoprostol group (7.77±0.88 hours), compared to oxytocin group (9.91±1.02 hours), which is statistically significant (p-value<0.001) and mean difference between them was (2.138 hours). Maternal satisfaction was more in misoprostol group (92%) compared to oxytocin group (62%) which is statistically significant (p-value<0.001). The rate of caesarean section was (18%) in oxytocin group & (12%) in misoprostol group (p-value=0.401) which is statistically insignificant, no difference of statistical importance seen with regard to indications of C/S, fetal distress, neonatal APGAR score <7, admission to neonatal intensive care unit, fetal weight and sex, and maternal adverse effects of the drugs.


Conclusion

In pre-labour rupture of membranes at term, it is effective, safe and economic to use misoprostol for induction of labour with low cervical Bishop score and is associated with shorter induction to delivery interval compared to oxytocin, with higher maternal satisfaction.



KEYWORDS

Pre-labour rupture of membranes at term; Induction of labour; Misoprostol; Oxytocin.