Comparison of Misoprostol and Dinoprostone for Induction of Labour in Full Term Pregnancy
DOI:
https://doi.org/10.70749/ijbr.v3i6.1588Keywords:
Misoprostol, Dinoprostone, Labor induction, EfficacyAbstract
Background: Labor induction is a common obstetrical practice, and a number of agents are effective in facilitating the process. Misoprostol and dinoprostone are two common medications, and their comparative effectiveness regarding labor length and success rate is a subject of continued investigation. Objective: To compare the efficacy of misoprostol and dinoprostone for labor induction at term. Study Design: Randomized controlled trial. Duration and Place of Study: The study was conducted from September 2024 to March 2025 at the Department of Obstetrics and Gynaecology, MTI-D.I. Khan. Methodology: 152 pregnant women were randomized into either the dinoprostone (Group B) or misoprostol (Group A) group, with an even split of participants in both groups of 76 each. Inclusion in the study was women presenting between the ages of 18 and 40 years, having a singleton gestation at term (39 weeks of gestation), intact amniotic membrane, and Bishop score ≤6. Induction of labor using either dinoprostone or misoprostol was conducted, and labor duration and success rate of vaginal delivery were noted. Results: Misoprostol demonstrated superior performance with a 75.0% success rate, compared to dinoprostone's 47.4% (p<0.001). Additionally, labor duration was significantly shorter in the misoprostol group, with an average of 10.66 ± 2.81 hours, compared to 13.84 ± 2.37 hours for dinoprostone. Stratified analysis revealed that misoprostol was particularly more effective in younger patients (≤30 years), as well as in those with fewer previous births and lower socioeconomic status. Conclusion: Misoprostol is a more effective and time-efficient agent for labor induction compared to dinoprostone.
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Debele TZ, Cherkos EA, Badi MB, Anteneh KT, Demssie FW, Abdo AA, et al. Factors and outcomes associated with the induction of labor in referral hospitals of Amhara regional state, Ethiopia: a multicenter study. BMC Pregnancy Childbirth. 2021;21(1):225.
https://doi.org/10.1186/s12884-021-03709-5.
Fasoulakis Z, Koutras A, Antsaklis P, Theodora M, Valsamaki A, Daskalakis G, et al. Intrauterine growth restriction due to gestational diabetes: from pathophysiology to diagnosis and management. Medicina (Kaunas). 2023;59(6):1139.
https://doi.org/10.3390/medicina59061139.
Flament E, Blanc-Petitjean P, Koch A, Deruelle P, Le Ray C, Sananès N, et al. Women satisfaction on choosing the cervical ripening method: oral misoprostol versus balloon catheter. Eur J Obstet Gynecol Reprod Biol X. 2023;19:100202.
https://doi.org/10.1016/j.eurox.2023.100202.
Corrêa TD, Barreto Junior AN, Batista MCM, Corrêa Júnior MD, Leite HV, et al. Analysis of variables that influence the success rates of induction of labor with misoprostol: a retrospective observational study. Rev Bras Ginecol Obstet. 2022;44(4):327-335.
https://doi.org/10.1055/s-0042-1744287.
Adu-Bonsaffoh K, Seffah J, et al. Factors associated with adverse obstetric events following induction of labour: a retrospective study in a tertiary hospital in Ghana. Afr Health Sci. 2022;22(4):348-356.
https://doi.org/10.4314/ahs.v22i4.40.
Erasto E, Manguzu MA, Nyondo GG, Kilonzi M, Marealle AI, Mutagonda RF, et al. Safety and effectiveness of different modes of labor induction among pregnant women delivering at referral hospitals in Dar es Salaam, Tanzania: a cohort study. BMC Pregnancy Childbirth. 2025;25(1):116.
https://doi.org/10.1186/s12884-025-07260-5.
Uvnäs-Moberg K. The physiology and pharmacology of oxytocin in labor and in the peripartum period. Am J Obstet Gynecol. 2024;230(3S):S740-S758.
https://doi.org/10.1016/j.ajog.2023.04.011.
Socha MW, Flis W, Pietrus M, Wartęga M, et al. Results of induction of labor with prostaglandins E1 and E2 (The RIPE study): a real-world data analysis of obstetrical effectiveness and clinical outcomes of pharmacological induction of labor with vaginal inserts. Pharmaceutics (Basel). 2023;16(7):982.
https://doi.org/10.3390/ph16070982.
Socha MW, Flis W, Pietrus M, Wartęga M, Stankiewicz M, et al. Signaling pathways regulating human cervical ripening in preterm and term delivery. Cells. 2022;11(22):3690.
https://doi.org/10.3390/cells11223690.
Mukherjee AA. Comparison of effectiveness of sublingual and vaginal misoprostol for second-trimester abortion. J Obstet Gynaecol India. 2019;69(3):246-251.
https://doi.org/10.1007/s13224-018-1183-8.
Svensk E, Bessfelt E, Brismar Wendel S, Kopp Kallner H, Wallström T, et al. Misoprostol as oral solution or oral tablet for induction of labour (MISOBEST): a randomised controlled non-inferiority trial. BJOG. 2025;132(3):288-296.
https://doi.org/10.1111/1471-0528.17986.
Kerr RS, Kumar N, Williams MJ, Cuthbert A, Aflaifel N, Haas DM, et al. Low-dose oral misoprostol for induction of labour. Cochrane Database Syst Rev. 2021;6(6):CD014484.
https://doi.org/10.1002/14651858.CD014484.
Bhatia A, Teo PL, Li M, Lee JYB, Chan MXJ, Yeo TW, et al. Dinoprostone vaginal insert (DVI) versus adjunctive sweeping of membranes and DVI for term induction of labor. J Obstet Gynaecol Res. 2021;47(9):3171-3178.
https://doi.org/10.1111/jog.14907.
Yan J, Yin B, Lv H. Comparing the effectiveness and safety of dinoprostone vaginal insert and double-balloon catheter as cervical ripening treatments in Chinese patients. Front Med (Lausanne). 2022;9:976983.
https://doi.org/10.3389/fmed.2022.976983.
Di Tommaso M, Pellegrini R, Ammar O, Lecis S, Huri M, Facchinetti F, et al. Safety of the use of dinoprostone gel and vaginal insert for induction of labor: a multicenter retrospective cohort study. Int J Gynaecol Obstet. 2025;168(3):1039-1046. https://doi.org/10.1002/ijgo.15952.
Papanikolaou EG, Plachouras N, Drougia A, Andronikou S, Vlachou C, Stefos T, et al. Comparison of misoprostol and dinoprostone for elective induction of labour in nulliparous women at full term: a randomized prospective study. Reprod Biol Endocrinol. 2004;2:70.
https://doi.org/10.1186/1477-7827-2-70.
Unni V, Mudanur SR, Yaliwal RG, Kori S. Comparative study of vaginal misoprostol tablet versus dinoprostone insert in induction of labor: a prospective interventional analysis. Cureus. 2025;17(3):e80026.
https://doi.org/10.7759/cureus.80026.
Mlodawski J, Mlodawska M, Armanska J. Misoprostol vs dinoprostone vaginal insert in labour induction: comparison of obstetrical outcome. Sci Rep. 2021;11:9077.
https://doi.org/10.1038/s41598-021-88723-5
Akhtar A, Talib W, Shami N, Anwar S. Induction of labour - a comparison between misoprostol and dinoprostone. P J M H S. 2011;5(4):617-619.
Durani TA, Younas S, Rasheed N. Comparison of misoprostol vaginal tablet with dinoprostone PGE2 vaginal pessary for induction of labour in full term pregnancy. JSZMC. 2018;9(2):1393-1395.
Biswas T. Misoprostol (PGE1) versus dinoprostone gel (PGE2) in induction of labour in late intra uterine fetal death with unfavourable cervix: a prospective comparative study. Int J Reprod Contracept Obstet Gynecol. 2015;4(1):35-37.
https://doi.org/10.5455/2320-1770.ijrcog20150206.
Unni V, Mudanur SR, Yaliwal RG, Kori S. Comparative study of vaginal misoprostol tablet versus dinoprostone insert in induction of labor: a prospective interventional analysis. Cureus. 2025;17(3):e80026.
https://doi.org/10.7759/cureus.80026.
Khan SM, Jadoon S, Muslim F, Qadir M, Khan H. Misoprostol versus dinoprostone for induction of labor in PROM: a randomized controlled trial. J Soc Obstet Gynaecol Pak. 2020;10(3):135-139.
Jahangir J, Kehkashan A, Siddiqui Y, Yousuf S, Shaheera S. Comparison between misoprostol and dinoprostone in inducing labour. Int J Acad Med Pharm. 2023;5(6):1388-1391.
https://doi.org/10.47009/jamp.2023.5.6.286.
Mohamed MF, Marai AR, Othman MEA. Comparison of misoprostol verses dinoprostone in induction of labour. Al-Azhar International Medical Journal. 2023;4(6):67-71.
https://doi.org/10.58675/2682-339X.1847.
Fayaz M, Tabassum H, Zia S. Comparison of efficacy of misoprostol and dinoprostone in inducing labour at term cases. P J M H S. 2017;11(1):463-465.
Iftikhar B, Baqai SM. Dinoprostone and misoprostol for induction of labour at term pregnancy. Pak Armed Forces Med J. 2016;66(5):631-636.
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