Healthcare professionals use misoprostol for labor induction as it causes uterine contractions and softens the cervix. Misoprostol regimen can be taken orally and vaginally to induce normal vaginal delivery. It is more effective than oxytocin as it results in fewer cesarean deliveries.Â
To know more about it, researchers tried to study the comparative effectiveness of taking misoprostol orally and vaginally for labor induction. The study published in Obstetrics & Gynecology was conducted between May 24, 2021, to September 19, 2022- involved 2546 pregnant women. Women with singleton pregnancy, gestation period of 37 weeks or more, intact membranes and cervical length of 2 cm or less were considered eligible for this research.Â
 Researchers randomly divided these pregnant women into two groups such as the oral misoprostol group, consisting of 1224 women in 37 clusters and the vaginal misoprostol group, consisting of 1322 women in 33 clusters. They were asked to take misoprostol orally or vaginally respectively. Â
The primary outcome of this single-center, cluster-randomized trial was normal vaginal delivery at the first attempt of induction and the secondary outcome included time to delivery, oxytocin requirement, the risk of chorioamnionitis and adverse maternal and neonatal outcomes. Â
When researchers observed and studied the collected data thoroughly, they noticed the primary outcome was the same for both groups, as 945 (77.2%) women in the oral misoprostol group and 1,032 (78.1%) in the vaginal misoprostol group delivered babies normally.Â
When they noticed the secondary outcome, researchers found that oxytocin requirement was lower in the vaginal misoprostol group than the oral misoprostol group as it was 68% and 78% respectively. On the other hand, other secondary outcomes such as time to delivery, the risk of chorioamnionitis and adverse maternal and neonatal outcomes- were the same for both groups. Â
The results of this study show that inducing labor by using misoprostol orally or vaginally did not increase the frequency of normal vaginal delivery. But it only reduces the oxytocin requirement before delivery.Â
Even though the results of this study show oral or vaginal misoprostol can not decrease the risk of cesarean deliveries, it is helpful as it reduces the use use of oxytocin requirement in pregnant women before their deliveries. These findings will be helpful for healthcare professionals to make effective strategies to increase the frequency of normal vaginal deliveries. Â
Reference Link:Â Â
Emily H. Adhikari et al, Vaginal Compared With Oral Misoprostol Induction at Term, Obstetrics & Gynecology (2023).Â
