Comparative study of vaginal misoprostol tablet versus dinoprostone insert in induction of labor

Abstract

Introduction: Induction of labor (IOL) is an essential obstetric procedure for maternal and fetal safety when continuing pregnancy is risky. Prostaglandin analogues like Misoprostol (PGE1) and Dinoprostone (PGE2) are commonly used for cervical ripening and labor induction. This study compares the efficacy and safety of vaginal tablet Misoprostol versus Dinoprostone insert in IOL. Aims and objectives : To compare efficacy and safety of the vaginal Tablet Misoprostol with Dinoprostone insert in induction of labour and to compare fetal and maternal outcomes.

Materials and Methods: This prospective, interventional study was conducted at BLDE University, Vijayapura, from April 2023 to February 2025, involving 106 pregnant women at term. Participants were divided into two groups: Group 1 received a 10 mg Dinoprostone vaginal insert, while Group 2 received 25 mcg vaginal Misoprostol every four hours. Key outcomes included vaginal delivery rates, cesarean section rates, and maternal and neonatal complications. Data were analyzed using SPSS (Version 20). Results: Vaginal delivery occurred in 73.58% of the Dinoprostone group compared to 50.94% in the Misoprostol group (p=0.02). The mean induction-to-delivery interval was significantly shorter in the Misoprostol group (15.2 ± 4.9 hours vs. 18.3 ± 4.29 hours, p<0.001). Maternal complications, including postpartum hemorrhage (PPH), were more common in the Misoprostol group (24.5%). Neonatal complications, such as NICU admissions and lower Apgar scores, were also significantly higher in the Misoprostol group.

Conclusion: Both Misoprostol and Dinoprostone are effective for labor induction, but Misoprostol shortens the induction-to-delivery interval at the cost of increased cesarean rates and fetal complications. Dinoprostone, while slower, shows better fetal outcomes and fewer complications, making it a preferable option for high-risk pregnancies. Tailoring the choice of induction agent based on patient-specific factors is essential.