Humaira Zaman Malik, Nuzhat Parveen Khawaja, Bushra Zahid, Rakhshanda Rehman.
Sublingual versus oral misoprostol for induction of labour in prelabour rupture of membranes at term.
J Coll Physicians Surg Pak Jan ;20(4):242-5.

Objective: To compare the efficacy of sublingual with oral misoprostol for induction of labour in primigravida with prelabour rupture of membranes at term. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Obstetrics and Gynaecology Unit-II, Sir Ganga Ram Hospital, Lahore, from June 2004 to January 2006. Methodology: The study included 100 primigravidas with singleton pregnancy at term, having pre-labour rupture of membranes and unfavourable Bishop score with no contraindication of induction of labour, vaginal delivery or misoprostol use. The cases were randomized into two equal groups, A and B. Women in the group A were given 100 ìg of misoprostol orally at an interval of 4 hours to a maximum of 2 doses while patients in the group B were prescribed the medicine sublingually (50 ìg, 4 hourly, maximum of 2 doses). Induction to delivery interval, mode of delivery and fetomaternal complications were main outcome measures of the study. Results: In the sublingual misoprostol group (B), 92% women delivered within 12 hours of induction while 84% of subjects delivered in this time period in oral group (A, p < 0.05). There was no failed induction in either group. Regarding dosage, 64% of women delivered with single dose in group B while only 32% delivered with single dose in group A (p < 0.05). The frequency of vaginal delivery was 92% in group B versus 80% in group A, while rate of caesarean section was 8% in the group B and 20% in the group A, which is statistically insignificant. No significant fetomaternal complications were seen in both groups. Conclusion: The efficacy of sublingual misoprostol in the dosage of 50 ìg was comparable to 100 ìg oral dose for the induction of labour in the primigravidas at term with pre-labour rupture of membranes.

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