Oral Misoprostol for Induction of Labour

Objective: To determine the effect of oral Misoprostol in tabour induction with respect to ease of administration and induction-to-delivery time interval. Study Design: Observational study. Place and Duration of Study: Gynaecology/Obstetrics Department, Holy Family Hospital, Rawalpindi, from March to August 2006. Methodology: Women with live singleton pregnancy of > 37 weeks gestation with cephalic presentation, with an indication for induction of labour were inducted. Oral misoprostol 50 mu g to 400 mu g was given in divided doses at 4 hours interval upto a maximum of 4 doses, till labour was induced. Fetomaternal outcome and induction to delivering time interval in hours was noted. Results: In 6 months duration, 250 mothers were recruited for the study. The main indication for labour induction was post date pregnancy (52%) and oxytocin was given in 50% cases. The majority (96%) of mothers went into labour but 4% (9) had failed induction. The majority (73%, n=176/241) of mothers delivered vaginally, 99% being delivered in the first 24 hours. Mean induction-delivery interval was 11 +/- 2.7 hours. Sixty five (27%) had to undergo emergency lower segment caesarean section, the major indication being fetal distress (41.5%, n=27) and meconium staining of liquor (40%, n=26). Again, a majority (95%) of the babies were delivered with good Apgar score. However, 10.8% developed meconium aspiration syndrome. Early neonatal deaths occurred in 0.8% (2) cases. Maternal hyper stimulation was seen in 1 case (0.4%). Conclusion: Oral misoprostol as an agent for labour induction in term pregnancy was easy to administer and the majority of women (99%) delivered in the first 24 hours.