Arati Achamma IPE1, Anoj Kattukaran2
OBJECTIVES/PURPOSE
To compare two dosing regimens of the same 25 mcg misoprostol with respect to Induction delivery interval, successful vaginal delivery and its associated maternal and neonatal outcomes.
METHODS
Prospective study was conducted among 300 low risk pregnant patients at 40 weeks’ gestation, attending labour room in the Dept. of OBG, Amala Institute of Medical sciences, comparing, A-single dose 25 mcg misoprostol in 24 hours Vs. B-multiple dose 25 mcg misoprostol (4 hourly up to 3 doses) intravaginally for its effectiveness.
RESULTS
Statistically significant difference was obtained in the number of deliveries within 24 hours in group A and B (36.6% Vs. 63.4% with p value 0.002). The induction delivery interval between primigravidae and multigravidae were statistically significant (12.5 =/-3.9 Vs 11.08=/-4.3 with p value 0.035) but not significant between groups A and B. There was no statistical difference in other maternal and neonatal outcomes. Incidence of MSL and foetal distress were higher in primigravidae after single dose itself. Serious adverse outcomes like MAS, NND, APGAR<7 at one minute and uterine rupture were not encountered in this study.
CONCLUSION
Around 65% of women delivered with a single dose of misoprostol in 24 hours. Most multigravidae delivered vaginally with a single dose in 24 hours. It appears that in multigravidae a single dose induction is adequate; however, in primigravidae multiple doses of 25 mcg misoprostol is best to achieve delivery within 24 hours.
