• Snehamay Chaudhuri, Sankar Nath Mitra, Pradip Kumar Banerjee, Pranab Kumar Biswas, and Sudipta Bhattacharyya.
• Department of Obstetrics and Gynecology, NRS Medical College, Kolkata, West Bengal, India. snehamay_chaudhuri_dr@yahoo.com
• J. Obstet. Gynaecol. Res. 2011 Nov 1; 37 (11): 1564-71.

Aim To compare immediate induction with vaginal misoprostol tablets and immediate induction with vaginal dinoprostone (naturally occurring prostaglandin E2 [PGE2]) gel in women with premature rupture of membranes (PROM) at term.MethodsTwo hundred and twelve women with PROM at term were assigned randomly to receive either an intravaginal 25 µg misoprostol tablet, 4-hourly, with a maximum of five doses, or 0.5 mg intravaginal PGE2 gel, 6-hourly, with a maximum of two doses. The primary outcome measures were the admission-to-delivery interval and the induction-to-delivery interval. Secondary outcomes included cesarean section rate, mode of delivery, and maternal and neonatal safety outcome. Results were calculated applying Fisher's exact test, χ2-test, t-test and calculating the P-value using an alpha level of 0.05 for Type I errors.ResultsThe mean time from admission to delivery was 13.53 h in the misoprostol group and 12.30 h in the PGE2 group (P = 0.090). The induction-to-delivery interval was also comparable between the groups (10.75 h vs. 9.37 h), while the cesarean section rate did not differ significantly between them (7.61% vs. 15.30%). More women in the misoprostol group had an instrumental delivery (12.38% vs. 2.94%). The only significant difference in neonatal outcome was a greater number of babies born with Apgar score < 7 at 1 min in the misoprostol group. Maternal outcomes were not significantly different, except for a higher number of digital vaginal examinations in the misoprostol group.ConclusionVaginal misoprostol is equally efficacious in labor induction and demonstrates a similar fetal and maternal safety profile to PGE2 gel.© 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

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