Comparative Effectiveness of Misoprostol and Dinoprostone for Induction of Labour at a Tertiary Care Setting

Abstract

Background: Induction of labour is a common obstetric surgery and good cervical ripening is the most important factor that can be used to predict its success. Prostaglandins are typically misoprostol and dinoprostone; though, they are not compared in terms of effectiveness in the real clinical contexts, especially in low-resource countries.

Purpose: This study will compare the efficacy and safety of misoprostol and dinoprostone in labour induction (measurements of progression of labour, mode of birth, and neonatal and maternal outcome).

Methods: This was a prospective comparative cohort study that was carried out in eight months (between January 2025 and August 2025) in Lady Willingdon Hospital, Lahore. One hundred and forty pregnant women in need of induction of labour were recruited and 70 in misoprostil group and 70 in dinoprostone group. The names of patients were assigned randomly. Baseline characteristics information, induction information, labour outcomes, mode of delivery, maternal complications, and neonatal outcomes were identified. The statistical analysis has been conducted with the help of relevant parametric and non-parametric tests. Multivariate logistic regression was used to correct the confounders such as age, parity, Bishop score and gestational age.

Results: There were similarities in baseline characteristics. The misoprostol group had shown considerably decreased doses needed, and oxytocin augmentation. The labour progression was markedly quicker with fewer time to active labour and delivery, and higher percentage of delivery took place within the period of 12 hours. The spontaneous vaginal birth rate was much greater and the rate of cesarean section was less in the misoprostol group. Mothers in both groups had the same complications. APGAR scores were significantly higher with neonatal outcomes using misoprostol and NICU admissions were also also less and not significant. Multivariate analysis affirmed that misoprostol was a predictor of vaginal delivery independently.

Conclusion: Misoprostol is a safe and effective alternative to dinoprostone in labour induction and has better labour outcomes (improved) without the need to raise maternal or neonatal complications.