A comparison of buccal versus vaginal misoprostol for induction of labour at term to correlate maternal and foetal outcome

Background: Induction of labour with prostaglandins offers the advantage of promoting cervical ripening with stimulation of myometrial contractility. The use of prostaglandin preparations with or without oxytocin infusion, widely recognized and accepted as a standard method of labour induction, has been shown to reduce induction time and the risk of failed induction. Methods: The present study was a prospective observational study undertaken in the obstetrics and gynaecology department of Adesh Medical College and Hospital, Kurushetra, Haryana, India from 01 June 2023 to 30 November 2023. Total 100 patents were randomly allocated to either group A (n=50) who receive 25 µg misoprostol buccally four hourly upto maximum of four doses, group B (n=50) who receive 25 µg misoprostol vaginally four hourly upto maximum of four doses. Various parameters noted were time interval from induction to vaginally delivery, mode of delivery, maternal adverse effect, and neonatal outcome. Results: The mean induction delivery interval in group I was 14.17 hours and 12.9 hours in group II. The mean number of doses in group I was 1.58±0.36 and 1.26±0.28 in group II. The mode of delivery in group I (buccal) patients was full-term vaginal delivery (FTVD) in 33 of patients, instrumental (forceps) 2 of patients and lower segment caesarean section (LSCS) in 15 of patients. While as in group II (vaginal) patients 35 of patients had FTVD, 1 had instrumental (forceps) and 14 had LSCS. The results of present study were indicated that participants who were treated with buccal misoprostol were suffering from gastrointestinal experiences and tachysystole which was the result of misoprostol dosage. Conclusions: Misoprostol in either buccal or vaginal route has proven to be equally effective for inducing labour in women at term pregnancy. This study found that the women who are treated with buccal misoprostol are suffering from gastrointestinal experiences more than vaginal misoprostol. However, easy intake is observed if the drug is administered buccally outweighs its advantages over the vaginal misoprostol.