RANDOMIZED COMPARISON OF MISOPROSTOL AND DINOPROSTONE FOR PREINDUCTION CERVICAL RIPENING AND LABOR INDUCTION

This study attempts to evaluate the clinical effects of prostaglandin (PG) E analogues in preinduction cervical ripening and labor induction and to compare the perinatal outcomes of these medications. Sixty wom en with term singleton pregnancies were randomized to receive dinopros tone vaginal tablets (group I) or misoprostol vaginal tablets (group I I). The Bishop scores were evaluated before drug insertion and every 4 hours during induction. Clinical data and perinatal outcomes were als o recorded. There were no significant differences in the preinduction conditions on mean initial Bishop scores between these hco groups, wer e hours after drug insertion, the mean Bishop scores were significantl y better in group II (9.7 +/- 3.1 vs 7.3 +/- 2.5, P < 0.05). The mean time fi om insertion to delivery was shorter in group II (16.5 +/- 2.7 h vs 25.7 +/- 3.8 h, P < 0.001). There were no significant difference s in spontaneous labor rate, need for oxytocin augmentation, type of d elivery, and Doppler flow velocity waveforms of the umbilical artery. The average number of doses given per patient was 1.8 +/- 1.4 in group II vs 2.7 +/- 0.3 in group I (P < 0.05). The perinatal outcome was si milar in the two groups. In conclusion, misoprostol not only appears t o be a safe and effective agent for cervical ripening and labor induct ion but is also more efficient than dinoprostone.