Oral vs Vaginal Misoprostol for Inducing Labor at Term: Randomized Controlled Trial

To assess the efficacy of oral and vaginal misoprostol for inducing labor at term. Methodology: Department of obstetrics at SIMS/ Services Hospital, Lahore, conducted a prospective randomized controlled trial from January 2023 to June 2024. Two hundred term patients with a live baby having cephalic presentation were divided into two groups to receive either 50 µgm misoprostol orally or vaginally. The main result measured was the proportion of vaginal deliveries occurring within a 24-hour period; Additional outcomes included cesarean section, fetal distress, uterine hyperstimulation, induction to delivery interval, NICU admissions and neonatal mortality. Results: Out of total 100 patients in each group, vaginal delivery within 24 hours was achieved by 67 patients (67.0%) in the oral group and 72 patients (72.0%) in the vaginal group, with no significant difference (p = 0.443). Cesarean rates were similar: 33 patients (33.0%) vs 28 patients (28.0%) (p = 0.443). Fetal distress was observed in 23 patients (23.0%) vs 24 patients (24.0%) (p = 0.868), and hyperstimulation occurred in 1 patient (1.0%) in each group (p > 0.999). Oxytocin use was significantly higher in the oral group: 41 patients (41.0%) vs 24 patients (24.0%) (p = 0.010). Neonatal outcomes were comparable, with Apgar scores >7 in 97 infants (97.0%) vs 96 infants (96.0%) (p = 0.700), along with comparable NICU admissions and neonatal mortality rates. Conclusion: Both oral and vaginal misoprostol are equally safe and effective for inducing labor at term, having good outcomes of vaginal birth with fewer complications.