Fetomaternal Outcomes Following Sub-Lingual and Vaginal Misoprostol for Induction of Labour: A Randomized Controlled Trial

Background: Induction of labour may become necessary to avert adverse obstetric outcomes in the course of pregnancy. The appropriate dosage and route for misoprostol administration for induction of labour is not well understood in our clinical setting. In our setting no studies have been carried out to compare the efficacy and safety of sub-lingual and vaginal misoprostol. Aim: To compare the fetomaternal outcome of events using the sub-lingual and vaginal routes for induction of labour. Methodology: One hundred and forty pregnant women at term who fulfill the inclusion criteria were equally randomized into the two arms of the study to receive either 25 µg of misoprostol sublingually or 25µg vaginally and fetal outcomes were compared in the two arms of the study. Results: The fetal and maternal outcome was not statistically significant between the vaginal and sublingual groups. The perinatal outcomes between the sublingual and vaginal misoprostol groups showed no statistically significant differences. Apgar scores at 1 and 5 minutes were similar, with few babies scoring below 7 at 1 minute and improving by 5 minutes. Neonatal intensive care unit admission was more common in the sublingual than vaginal group, but the difference was not significant. The main indications for neonatal intensive care unit admission were birth asphyxia, sepsis, and respiratory distress, with no significant difference between groups. Maternal side effects were comparable between the two groups, with no statistically significant differences across all parameters. Although the vaginal misoprostol group showed slightly higher frequencies of nausea, shivering, flushing, tachysystole, and hyperstimulation, these differences did not reach statistical significance (P > 0.05). Conclusion: The sublingual and vaginal routes for administration of misoprostol for induction of labour showed comparable feto-maternal outcomes.