Aalia Tayyba, Mehreen, Nosheen.
Comparison between Sublingual and Vaginal Misoprostol for Labor Induction at Term.
Pak J Med Health Sci Jan ;7(4):1038-41.

Aim: To compare the efficacy and safety of 50 microgram of sub-lingual misoprostol with 25 microgram of vaginal misoprostol administered for labor induction at term. Design: Randomized control study Place and duration: Surayya Azeem (waqf) Hospital from May, 2011 to November 2012. Method: Total of 140 women at term with indication of induction were included in the study. Women were randomized to receive either 50 microgram of sub-lingual misoprostol with vaginal placebo or sub-lingual placebo with 25 microgram of vaginal misoprostol every four hours. The number of women delivering vaginally within 24 hours of labor induction. Results: 58 women (83%) in the sub-lingual misoprostol and 53 (76%) in the vaginal group delivered vaginally within 24 hours (relative risk RR 1.1). However, the induction to vaginal delivery time was significantly shorter in the sub-lingual group (15  3.7 hrs compared with vaginal group 16.7  4.1 hours. P=0.03). The incidence of tachysystole was more than three fold higher in the sublingual than in vaginal group. 14 versus 4.3%, RR 3.3, 95% (CI) confidential interval 0.9-11.6 but this was not statistically significant. There were no significant differences in the incidence of hypertonus or hyper stimulation syndrome, mode of delivery, intervention for fetal distress or neonatal outcomes between the two groups. Conclusion: A 50 microgram of sublingual misoprostol four hourly for labor induction at term seems to have similar efficacy as 25 microgram of vaginal misoprostol.

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