Misoprostol Sublingually Versus Vaginally for Labor Induction at Term: A Randomized Study

Objective: To compare the efficacy of misoprostol 50 μg vaginally and 50 μg sublingually for labor induction at term. Materials and Methods: One hundred and twenty women were randomized to receive misoprostol 50 μg vaginally (n = 60) or 50 μg sublingually misoprostol (n = 60). The doses were given every 5 h (maximum 5 doses). Primary outcome measure was vaginal delivery rate. Induction to delivery time, delivery within 12 h, the number of misoprostol doses given and neonatal outcomes were secondary outcome measures. Results: Vaginal delivery rates were 75% in the sublingual group and 73% in the vaginal group (RR, 1.09; 95% CI, 0.4 - 2.4).The number of women delivering within 12 h was 20 (45.5%) in the vaginal group and 12 (27%) in the sublingual group (RR, 0.5; 95% CI, 0.3 – 1). There were no significant differences in the number of doses needed, incidence of contractility disturbances, or neonatal results. Conclusion: Sublingual misoprostol is as efficacious as vaginal misoprostol for induction of labor and neonatal outcomes are similar.