Efficacy and safety of labor induction by oral versus vaginal misoprostol–study of 200 cases in private setup

: Labour induction is an important obstetric procedure aimed at achieving vaginal delivery when pregnancy extends beyond term or the cervix is unfavorable. Misoprostol, a prostaglandin E1 analogue, is commonly used due to its effectiveness, low cost, and ease of storage. It can be administered orally or vaginally, with varying efficacy. This study compares the safety and efficacy of both routes for cervical ripening and labour induction. To evaluate the efficacy and safety of vaginal versus oral misoprostol for third-trimester cervical ripening and labour induction in 200 patients at Mahavir Hospital, Surendranagar, Gujarat. This prospective study enrolled 200 pregnant women requiring labour induction with misoprostol between October 2023 and September 2024. Participants were assigned to either vaginal or oral misoprostol (25 micrograms). Labour progress was monitored using WHO partographs. Primary outcomes included induction-to-delivery interval and mode of delivery, while secondary outcomes included maternal and neonatal outcomes and complications. : Vaginal misoprostol was more effective for cervical ripening and reduced caesarean section rates compared to oral misoprostol. Of the 200 women, 100 received vaginal misoprostol, and 100 received oral misoprostol. Spontaneous vaginal delivery rates were similar (67% for oral, 68% for vaginal), and both routes showed higher spontaneous vaginal delivery rates (68%) compared to caesarean sections (12%). The vaginal group had a shorter induction-to-delivery interval. Additionally, more oral misoprostol patients (42) required multiple doses than vaginal misoprostol patients (55). Minimal side effects were reported. : Misoprostol, especially when administered vaginally, is a safe and effective method for labour induction. Vaginal misoprostol showed slightly better efficacy, reduced caesarean section rates, and shorter induction times compared to oral misoprostol. Ongoing monitoring is essential to ensure safety and improve outcomes for both mothers and babies.