spontaneous onset of labor, with or without rupture of membranes. When the cervix is unfavorable, cervical ripening with prostaglandins to soften and open the cervix will often commenced to induce labor.
Objective: To compare 50 μg of sublingual misoprostol to 50 μg of vaginal misoprostol for induction of labour at term regarding efficacy and safety.
Patients and Methods: This prospective randomized controlled trial included 104 pregnant women who were recruited from Department of Obstetrics and Gynecology, Faculty of Medicine Ain-Shams University and Al-Glaa Teaching Hospital, Delivery Unit.
Results: Regarding induction-delivery interval (time from given drug for both groups to vaginal delivery), there was no significant statistical difference between both groups regarding the mean time from initial dose to the delivery. Mean 15.04 ± 4.67 for sublingual group versus 14.16 ± 4.45 for vaginal group (P= 0.331). As regarding fetal and maternal complications in our study, there was significant statistical difference between the vaginal and sublingual groups according to secondary outcome (hyperstimulation). The risk of hyperstimulation was higher in vaginal group (5 cases) compared to the sublingual group (No cases) P= 0.046.
Conclusion: Sublingual misoprostol 50 μg administered at 6 hourly intervals is as effective in promoting cervical ripening and inducing labor as vaginal misoprostol 50 μg administered 6 hourly intervals as regarding induction to delivery interval, number of doses, shorter hospitalization and neonatal outcome. Sublingual misoprostol 50 μg has a higher maternal and perinatal safety profile than the vaginal 50 μg misoprostol including cesarean rates due to fetal distress, adverse maternal outcomes as hyperstimulation.
Recommendations: We recommend sublingual 50 μg misoprostol administered at 6 hourly intervals as an efficacious and safe option for labor induction, low cost and availability is its added benefits