A Comparison of Misoprostol and Prostaglandin E2 Vaginal Tablet for Cervical Ripening of the Unfavorable Cervix and Induction of Labor at Term Pregnancy

Lee, G M; Song, T B; Kim, Y H; Pyun, J S

Abstract

OBJECTIVE
The goal of this study is to compare the safety and efficacy of intravaginal misoprostol with that of intravaginal PGE2 for labor induction and cervical ripening in term pregnancy.
METHODS
Fifty nine patients with indications for induction of labor with unfavorable cervices were randomized to received either 50 microgram misoprostol or 3mg PGE2 intravaginally. Among 59 patients recuited, 30 received misoprostol and 29 received PGE2. The second dose was repeated 6 hours after first dose, if the cervices were unfavorable. At 6 hours after applying second dose, the cervices were reevaluated.
RESULTS
Regular uterine contraction and/or successful cervical ripening[Bishop score > or =7] after administration of one dose was statistically more often in the misoprostol group than that in the PGE2 group[60% vs 31%, p<0.05]. No difference was noted in successful induction rate after two doses administration between misoprostol group and PGE2 group[23.3% vs 27.6%]. Total 25[83.3%] in misoprostol group & 17[58.6%] in PGE2 group were achieved successful cervical ripening or labor induction by each drug[p<0.05]. There were no significant differences in the mean time to delivery, the need for oxytocin, delivery within 24hours. No significant differences were noted in cesarean section rate, frequency of tachysystole[20% vs 10.4%] and hyperstimulation[3.3% vs 6.9%], and neonatal outcomes between two groups.
CONCLUSION
Intravaginal administration of misoprostol is an effective and inexpensive agent for cervical ripening and induction of labor. Misoprostol 50 microgram was acceptable as initial dosage for unfavorable cervices in term pregnancy compared with PGE2 3 mg. Complications were not statistically different between two groups.