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Category: Volume 08 Issue 01 January 2020
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Title: Compare the Efficacy and Safety of Misoprostol for Induction of Labour at Term Singleton Pregnancies by Intravaginal versus Sublingual Route

Authors: Ningthoujam Manganthoi Meitei, Namoijam Basanti, Ahanthem Sanaton

 DOI: https://dx.doi.org/10.18535/jmscr/v8i1.166

Abstract

Background: Induction of labour implies stimulation of contractions before the spontaneous onset of labour, with or without rupture of membranes. Common indications of labour induction include post-dated pregnancies, intra-uterine growth restriction, pregnancy induced hypertension, non-reassuring fetal status and various medical conditions such as chronic hypertension and diabetes. In routine clinical practice, there are only two classes of drugs which are seriously considered for cervical ripening and induction of labour, namely prostaglandins (E1 and E2) and oxytocin.

Materials and Method: The study was a prospective randomized study comprising of all women above 18 years with singleton term gestation in cephalic presentation with parity 1 to 3 with normal FHR and no contraindication for induction both for mother and the fetus admitted in JNIMS between October 2017 and September 2019.

Results: Delivery with a single dose was almost same in both the two groups. Normal vaginal delivery was more among intravaginal group but ventouse and LSCS was more among sublingual group but the finding was statistically insignificant. Maternal and fetal complications were comparable in between the two study groups.

Conclusion: The sublingual route of administration of misoprostol is comparable in efficacy and safety to the vaginal route for induction of labour.

Keywords: Induction, Misoprostol, Sublingual, Intravaginal

References

  1. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al, editors. William Obstetrics. 24th New York: Mc Graw- Hill; 2014.
  2. Stephenson ML, Wing DA. A novel misoprostol delivery system for induction of labour. Drug Des Devel Ther 2015;9(1):2321-7.
  3. Caliskan E, Bodur H, Ozeren S, Corakei A, Ozkan S, Yucesoy I, Misoprostol 50 mcg sublingually versus vaginally for labour induction at term. Gynaecol Obstet Invest 2005;59(3):155-61.
  4. Fletcher HM, Mitchell S, Simeon D, Freidrick J, Brown D: Misoprostol for labor induction at term. Br J Obstet Gynaecol. 1993;100:641-4.
  1. Hassane EM, El Karroumi M, Mikou F, Ghazil M. Misopristol sublingual versus vaginally for induction of labour at term. Res ObstetGynaecol 2012;1(3):279-83.
  2. Akare MD, Patel PK. A comparison of sublingual with vaginal administration of misoprostol for induction of labor at term. Int J Reprod Contracept Obstet Gynecol 2017;6:1398-403
  3. Souza AS, Amorim M, Feitosa F. Comparison of sublingual versus vaginal misopristol for the induction of labour. Int J Obstet Gynaecol 2008;115(1):1340-9
  4. Rahman H, Pradhan A, Kharta L, Renjhen P, Kar S, Dutta S. Comparative Evaluation of 50 Microgram Oral Misoprostol and 25 Microgram Intravaginal Misoprostol for Induction of Labour at Term: A Randomized Trial. Journal of Obstetrics and Gynaecology Canada 2013 May;35 (5):408-16.
  1. Sheikher C, Suri N, Kholi U. Comparative Evaluation of Oral Misoprostol, Vaginal Misoprostol and Intracervical Folley’s Catheter for Induction of Labour at Term. JKScience. 2009;11(2):75-7.8. Sharami SH, Milani F, Faraji R, Bloukimoghadam K, Salamat F, Momenzade S, et al. Comparison of 25 mcg sublingual and 50 mcg intravaginal misopristol for cervical ripening and labour. Arch Iran Med 2014;17(10):652-6
  2. Haas DM,  Daggy J,  Flannery KM,  Dorr ML,  Bonsack C, Bhamidipalli SS, Pierson RC, Lathrop A, et al. A comparison of vaginal versus buccal misoprostol for cervical ripening in women for labor induction at term (the IMPROVE trial): a triple-masked randomized controlled trial. Am J Obstet Gynecol. 2019;211(3): 259.e1-259.e16.
  3. Muzonzini G, Hofmeyr GJ. Buccal or sublingual misoprostol for cervical ripening and induction of labour. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD004221.
  1. Gattas DS, Souza AS, Florentino AV, Nobrega BV, Fook VP, et al. Low dose of sublingual misopristol 12.5 mcg for labour induction. Rev Bras GynaecolObstet 2012;34(4):164-9.
  2. El Kattan AE, Moety GAA, AbdEirazek AA, Sublingual versus vaginal misoprostol for induction of labor in term primigravidas: a randomized study.Evid Based Women Health J. 2013;3(2):111–4.
  1. Jahromi NB, Poorgholam F, YousefiGhH, Salarian L. Sublingual versus Vaginal Misoprostol for the Induction of Labor at Term: A Randomized, Triple-Blind, Placebo-Controlled Clinical Trial. Iran J Med Sci. 2016;41(2):79-85.
  2. Malik HZ, Khawaja NP, Zahib B, Rehman R. Sublingual versus vaginal misopristol for induction of labour at term. J coll physicians Surg Pak 2010;20(9):242-5.
  3. Ayati S, Vahidroodsari F, Farshidi F, Shahabian M, Afzal Aghaee M. Vaginal versus sublingual misopristol for labour induction at term andpost term. Iran J Pharm Res 2014;13(1):299-304.

Corresponding Author

Ningthoujam Manganthoi Meitei

Post Graduate Trainee, Final Year, Department of Obs & Gynae, JNIMS, Imphal, Manipur