Comparative Study Between Oral and Vaginal Misoprostol for Induction of Labor in Nulliparous Pregnant Women at or Beyond Completed 41 Weeks

Background: Misoprostol applied vaginally has been shown to be an effective method of inducing labor; nevertheless, pregnant women may be resistant to digital examination and there is a possibility of infection. Therefore, oral misoprostol was attempted to induce labor. Objective: The aim of this study was to evaluate the safety and effectiveness of vaginal versus oral misoprostol for inducing labor in nulliparous women at or after 41 completed weeks of pregnancy. Materials and Methods: Eighty nulliparous women, divided into two groups, were eligible for labor induction at 41 weeks or more. In Group 1, 40 pregnant women got 25 μg vaginal misoprostol every six hours until a response was achieved, with a maximum of four doses. For Group 2, 40 pregnant women took oral misoprostol at a dose of 25 μg every six hours until a response was obtained, with a maximum of four doses. Results: Oral and vaginal misoprostol were comparable regarding the duration from inducing labor to onset of the active stage, interval from inducing labor to the delivery, cesarean deliveries, dosage requirements, and maternal and neonatal outcomes. However, the process of labor augmentation with oxytocin was dramatically reduced in the vaginal group. Conclusion : 25 μg oral misoprostol is as effective and safe as 25 μg vaginal misoprostol for inducing labor in nulliparous women with an unripe cervix at or beyond completed 41 weeks.