Incidence of Fetal Distress in 6 Hourly Vaginally Administered 3 Doses, of Misoprostol Versus Dinoprostone for Labour Induction: A Comparative Study

摘要

Abstract: Background: Artificial labor pain always poses the risk of fetal distress and is more painful than spontaneous labour. The pharmacological agents that are involved in stimulating uterine contraction may initiate a chain of processes that may lead the baby to suffocate, being deficient of essential oxygen and suffer from distress. The accelerated efforts to adapt safe and advanced measures are inevitable to make the labour induction easier and more secure for both lives involved. Objective: The objective of this study was to compare the incidence of fetal distress in 6 hourly vaginally administered 3 doses, of misoprostol versus dinoprostone for labour induction. Methods: This observational type of comparative study was conducted in Obstetrics Ward Lady Aitchison Hospital Lahore. A total of 200 postdate primigravidas undergoing induction of labour at 41 weeks were selected for this study. They were randomly divided into misoprostol and dinoprostone group, each containing 100 patients.The dose of misoprostol was 50 microgram each time up to a maximum of 150 microgram (3 doses) and dose of dinoprostone was 2 mg and only 2 doses of dinoprostone were used with an interval of 6 hours. Continuous fetal heart rate monitoring was done after induction. Signs of fetal distress like meconium staining of liquor after rupture of membranes and CTG changes were noted. After delivery of baby Apgar score at 5 minutes was taken and any resuscitation required or need for keeping the baby in nursery was noted. Results :The mean age of the patients in misoprostol group was 25.4±4.5 years and in dinoprostone group was 23.3±3.4 years. The mean duration of induction to delivery interval in misoprostol group was 16.4±6.4 hours and in dinoprostone group was 13.1±4.6 hours. In misoprostol group, 40 (40%) patients delivered with LSCS and 60 (60%) patients delivered with spontaneous vaginal delivery. In dinoprostone group, 36 (36%) patients delivered with LSCS and 64 (64%) patients delivered with spontaneous vaginal delivery. The mean Apgar score at 5 minutes in misoprostol group was 8.5±0.9 and in dinoprostone group was 8.6±0.9. In misoprostol group, there were 5 (5%) patients who were admitted in intensive care unit and in dinoprostone group 2 (2%) patients were admitted in intensive care unit. Conclusion: It is concluded from this study that the incidence of fetal distress did not increase when compared to dinoprostone when misoprostol is used at the dose of 50 mcg for induction of labour without decreasing its efficacy regarding induction and delivery.