3. A comparative study of outcome of labour induction with vaginal misoprostol versus intravenous oxytocin in premature rupture of membranes beyond 36 weeks of gestation

Induction of labour is indicated, when it is agreed that the fetus or mother will benefit with a higher probability of a healthy outcome, than if birth is delayed. Oxytocin is being used for decades for the purpose of labor induction in premature rupture of membranes (PROM). misoprostol (PgE1), a newer prostaglandin has shown promising results for the same purpose. The efficacy and safety of vaginal misoprostol and intravenous oxytocin for labor induction, in premature rupture of membranes beyond 36 weeks of gestation was evaluated and compared. A prospective randomized study of two hundred women (100 each from vaginal misoprostol group and intravenous oxytocin group) with premature rupture of the membranes beyond 36 weeks' of gestation, was carried out for two years at Pravara Rural Hospital, Loni. Results were analysed using Statistical Package of Social Sciences (SPSS) v13.0. Induction to delivery interval was significantly longer (p<0.05) in oxytocin group (7.17±1.20h in primigravidas and 6.06±1.09h in multigravidas) as compared to misoprostol group (6.61±1.06 h in primigravidas and 5.27±1.11 h in multigravidas). Mean induction delivery interval with misoprostol was 8.5h and with oxytocin was 9.3h. Labor induction with oxytocin infusion in PROM cases, beyond 36 weeks of gestation, in an unfavorable cervix was associated with higher rate of failed induction, longer duration of labor and higher rate of cesarean section, in comparison to those with vaginal misoprostol.