Titrated Oral Misoprostol Solution Versus Intravenous Oxytocin for Augmentation of Labour

Abstract

Objective:To compare the efficacy of titrated oral mis oprostol solution with intravenous oxytocin for augmentation of labour in term primigravidae in active phase of labour with inadequate uterine contractions. Methodology:This randomized control trial was conducted in the department of Gynaecology and Obstetrics, Pakistan Institute of Medical Sciences, Islamabad, over a period of six months from 14-April to 13-October, 2014. A total of 760 (two groups of 380 each) primigravidae, between age 20-39 years, who had completed 37-42 gestational weeks by dates, or by ultrasound scan, with regular contractions and an effaced cervix dilated between 3-4 cm, and who later developed inadequate uterine contractions during the first stage of labour were included in the study. Group A received titrated oral misoprostol solution 200μg tablet dissolved in 200ml tap water and 20ml (20μg/hour) and group-B was given Intravenous oxytocin (10 units in 1000cc Hartman’s solution at 8 drops/minute, doubling every 30 minutes up to a maximum of 64 drops/min for 2 hours). Results: Mean (±SD) age of the patients was 26.4±4.4 and 26.6±4.6 years in group-A and B respectively. In group-A, 322 patients (84.7%) and in group-B 326 patients (85.8%) were delivered vaginally. Mean (±SD) augmentation to delivery interval was 293.82±99.36 and 311.65±106.73 minutes in group-A and B respectively. Mean (±SD) gestational age in group-A was 38.82±1.32 and in group-B 38.83±1.09 week. Caesarean section was performed in rest of the patients in both groups. There was no significant association between mode of delivery in both groups (P-value= 0.682). Conclusion:Labour augmentation with titrated oral misoprostol or intravenous oxytocin resulted in about similar rates of vaginal delivery