Effectiveness of sublingual versus oral misoprostol for induction of labour at term

Objective: To compare the efficacy and safety of 50microgram (mg) sublingual Misoprostol with 50 microgram (mg) oral misoprostol for labour induction at term. Method: One hundred twenty women with medical or obstetric indication for induction of labour at term with unfavorable cervix were randomized to receive 50mcg of misoprostol either orally or sublingually. Primary outcome was number of women delivering vaginally within 24hrs of induction. The need for oxytocin, mode of delivery, doses of Misoprostol required and neonatal outcomes were analyzed and compared between the groups. Results: Induction to vaginal delivery time was < 24hours in 43(71.7%) in sublingual group and 36(60%) women delivered vaginally in < 24hours in oral group. No significant difference was found in the number of women delivering vaginally within 24hrs of induction among both the groups.Time from administration of first dose to delivery in sublingual group was lesser compared to oral group. 46.7% of women required oxytocin in sublingual groups, whereas 75% in oral group which was statistically significant. Sublingual group had lesser number of women requiring more than 1 dose of misoprostol compared to the oral group. Conclusion: Sublingual misoprostol seems to be having better efficacy than the oral misoprostol and has lesser induction to delivery interval. Hence can be considered to induce labour at term for ripening of cervix.