A comparative study of oral versus vaginal misoprostol in induction of labour at term prelabour rupture of membranes

Abstract

Background: Prelabour rupture of membranes(PROM) is characterized by the spontaneous rupture of the fetal membranes before the onset of labor. This study aims to determine the effectiveness of oral or vaginal route of misoprostol for induction of labor and successful vaginal delivery with unfavorable cervix with PROM.

Methods: This comparative study included 102 pregnant women with term PROM beyond

37 weeks of gestation. Participants were randomly assigned to receive either oral misoprostol(25 mcg every 4 hours) or vaginal misoprostol(25 mcg every 4 hours) until adequate labor contractions were achieved or a maximum of six doses.

Results: The study included 102 participants, with 55(53.9%) receiving oral misoprostol and 47(46.1%) receiving vaginal misoprostol. The majority of participants were 25 years or younger, with 21(35.0%) in the oral group and 30(50.0%) in the vaginal group. The mean gestational age was similar between the   oral(39.07   ±   0.76   weeks)   and   vaginal (38.85 ± 0.69 weeks) groups. The Bishop score showed no significant difference between the two groups. Ultrasound findings(Amniotic Fluid Index) and hemoglobin levels showed no significant differences between the groups(AFI p = 0.426, Hemoglobin p = 0.603). Our study found no significant difference in the induction-to- delivery interval between the oral (9.65 ± 1.14 hours) and vaginal(9.93 ± 1.05 hours) groups. The APGAR scores of newborns were slightly higher in the oral group(8.30 ± 0.46) compared to the vaginal group(8.12 ± 0.61). Conclusion:. These findings suggest that the choice of misoprostol administration route should be individualized based on patient characteristics and clinical circumstances.