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Comparison between vaginal misoprostol and cervical dinoprostone for cervical ripening and labor induction
1Department of Obstetrics and Gynecology, University of Tennessee Medical Center, Knoxville Unit, 1924 Alcoa Hwy., Knoxville, TN 37920, USA.
Objective:
To compare the efficacy of intravaginal misoprostol (Cytotec) to intracervical dinoprostone (Prepidil) for pre-induction cervical ripening.
Methods:
Sixty-one patients admitted for induction of labor, whose cervices were unfavorable (Bishop score: 4), were randomly assigned to either intravaginal placement of a 50 micrograms misoprostol tablet or intracervical administration of dinoprostone gel.
Results:
Eighteen women (56%) in the misoprostol group and five (17%) in the dinoprostone group achieved cervical ripening within 12 hours (P = 0.007). Fewer doses of misoprostol were required to achieve cervical ripening, and the interval from induction of labor to delivery was shorter in the misoprostol group. Sixteen patients (50%) in the misoprostol group required oxytocin, whereas 26 (90%) in the dinoprostone group required oxytocin augmentation (P = 0.008). There was no significant difference in mode of delivery or neonatal outcome between the two groups.
Conclusion:
Vaginal misoprostol appears to be a more effective cervical ripening agent than cervical dinoprostone.