Maternal and fetal outcome in vaginal misoprostol induced patient

Abstract

Aim: To study the effect of low dose vaginal misoprostol (25 µg) in induction of labour, To study the maternal and fetal outcome. Design: Retrospective case control study at Kamla Raja Hospital, GRMC, Gwalior from 01 Jan. 2018 to 31 Aug. 2019. Methods: Total of 200 Primi gravida women were randomized into 2 groups. Women induced with misoprostol 25 mg for cervical ripening labour induction and control group with no  induction and watch for spontaneous progress of labour. BISHOP's prelabour scoring system was used to assess whether the cervix was favourable for induction of labour or not. Every 4th hour per vaginal examination was done to note the progress of labour in terms of dilatation, effacement and descent of the presenting part. Results: The conclusion of the study, in present study, majority of the cases in the age group 18-24 years of age, case group mostly had unfavorable cervix and Bishop Score ≤ 6. There was a significant difference seen in induction to start of active labour in both groups (p <0.05). The maximum number of patients who go in active labour with in 6 hours more in case group i.e. improvement bishop score after induction, while in 6-12 hrs interval for induction to start of labour is more in control group (as there bishop score was higher at the admission) (Χ2 = 26.56  p value = 0.000008). Induction to delivery interval was statistically significant found in both group. Most of the patients delivered within 24 hours of induction in the both groups. Case group with in 6-12 hrs. interval 72 cases (who had poor bishop score and got improve after induction), control group < 6 hrs. 68 cases (there bishop score was higher at the admission) (Χ2 = 72.19 p value = 0.000001). Conclusion: Misoprostol is an effective priming and labour inducing agent. Though incidence of meconium stained liquor is higher in misoprostol induced labour among women with unfavourable cervix thereby increasing the rate of cesarean delivery for meconium stain liquor and increasing maternal as well as fetal morbidity and mortality.

Keywords: Induction of labour, Bishop Score, Misoprostol, Cervical ripening.