Efficacy and clinical prognosis of sublingual Misoprostol versus Misoprostol oral solution in the artificial induction of labor in primiparous women in the province of South Kivu at HGR Panzi

Abstract

Introduction: Induction of labor with Misoprostol is frequently used in obstetrics. However, complications related to the route of administration and the doses used are often reported. The aim of this study is to compare the sublingual route with the oral solution for administering Misoprostol.

Methods: This was a prospective, comparative study. Data collection took place from July 01, 2021 to January 31, 2023. Including primiparous volunteers divided into two groups. Analysis was performed using XLSTAT 2014 software, and fetal and perinatal prognosis was assessed using the Kaplan-Meier survival curve.

Results: In this study, 144 primiparous women were collected, of whom 11 died before induction. The age of the primiparous women ranged from 21 to 30 years in 72.2% of cases, with an average age of 23.6 years. Sublingual administration of Misoprostol was 3 times more likely to induce meconium than oral solution (OR 3.4 (95% CI [1.2-9.6] and p=0.016). The most prevalent indication was over-term, found in 75% of primiparous women who had received Misoprostol sublingually, whereas in primiparous women who had received the oral solution, preeclampsia was found in 52.2% of cases (p<0.001). ERCF was pathological in 57.9% of cases with the sublingual form versus 42.1% with the oral solution (p=0.047). At the first dose administered, a cumulative survival rate of 77.8% for the sublingual route versus 84.6% for the oral solution was observed.

Conclusion: Misoprostol induction of labor in primiparous women using Misoprostol oral solution also gives good results, like sublingual Misoprostol, in the artificial induction of labor, with a reduced rate of fetal distress.