Comparative Study of Sublingual Misoprostol and Dinoprostone Gel in Labour Induction and Its Implication on Maternal and Neonatal Outcome

Abstract

Effective and safe induction of labour is crucial in modern obstetric practice. This study aims to compare the efficacy and safety of sublingual misoprostol versus dinoprostone gel in inducing labour. A prospective, randomized controlled trial was conducted at a tertiary care hospital. A total of 828 pregnant women requiring labour induction were randomly assigned to receive either sublingual misoprostol (n=414) or dinoprostone gel (n=414). The primary outcome was the success rate of labour induction, defined as vaginal delivery within 24 hours. Secondary outcomes included the time interval from induction to delivery, incidence of hyperstimulation syndrome, mode of delivery, and maternal and neonatal outcomes. Data were analyzed using SPSS, with statistical significance set at p<0.05. The success rate of labour induction was significantly higher in the misoprostol group (78%) compared to the dinoprostone group (65%) (p<0.001). The median time from induction to delivery was shorter for sublingual misoprostol (10.5 hours) than for dinoprostone gel (14 hours) (p<0.001). Hyperstimulation syndrome occurred more frequently in the misoprostol group (12%) than in the dinoprostone group (7%) (p=0.02). There were no significant differences between the groups in terms of mode of delivery, maternal outcomes (postpartum hemorrhage, need for blood transfusion, infection), or neonatal outcomes (Apgar scores at 1 and 5 minutes, NICU admissions). Sublingual misoprostol is more effective than dinoprostone gel in achieving vaginal delivery within 24 hours of induction. It also shortens the time to delivery but is associated with a higher incidence of hyperstimulation syndrome. Both methods are otherwise comparable in terms of maternal and neonatal safety. These findings support the use of sublingual misoprostol for labour induction, with careful monitoring for hyperstimulation.