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A Comparison of 25 μg with 50 μg Misoprostol for Cervical Ripening and Induction of Labor

Francis Olayemi Adebayo, Olatunde Onafowokan and Nathaniel Adewole

Background: Misoprostol is increasingly being accepted as a standard agent for cervical ripening and induction of labor. The lowest effective dose is still not known. Materials and Methods: This was an open label clinical trial of one hundred and eighty four women with obstetrics or medical indications for induction of labor at University of Abuja Teaching Hospital, Abuja. Women were grouped to receive either 25 μg or 50 μg of intravaginal misoprostol. The main outcome measure was inductionvaginal delivery interval while the secondary outcome measures were requirements for oxytocin augmentation, mode of delivery, frequency of tachsystole/hyperstimulation, as well as feto-maternal outcomes. Data was analyzed using SPSS version 21.0. Chi-square test was used to compare categorical variables. Mann-Whitney test was used to analyze continuous variables of the two treatment groups. P-value of less than 0.05 was accepted as indicating statistical significance. Results: Mean induction delivery interval was 13.8 ± 5.9 and 14.0 ± 5.7 hours (P=0.842) with the 25 μg and 50 μg misoprostol respectively. The delivery rate within 24 hours of 66.3% (61/92,) in 25 μg group was lower than 67.4% (62/92) recorded in the 50 μg group but the difference was not statistically significant (P=0.156). The rates of caesarean section and operative vaginal delivery were similar in both groups. There were no significant difference in maternal side effects and neonatal outcomes among the women in the two groups. Conclusion: There were no statistically significant differences in the effectiveness and safety of either of the dose regimen over the other. The choice may therefore be guided by the physician’s experience, availability and/or departmental protocol.