Sublingual vs. vaginal misoprostol for induction of labor.

OBJECTIVE

To compare sublingual with vaginal misoprostol for the induction of labor.

METHODS

This double-blind clinical trial randomized 150 women to receive every 6 h 25 mug of sublingual misoprostol and vaginal placebo or 25 mug of vaginal misoprostol and sublingual placebo. Maternal and neonatal outcomes were analyzed and risk ratios (RRs) with 95% confidence intervals (CIs) calculated. The significance level was 5%.

RESULTS

Vaginal delivery rates were 57% in the sublingual group and 69% in the vaginal group (RR, 0.8; 95% CI, 0.6-1.1). There were 11 cases of fetal distress in the sublingual group and 4 cases in the vaginal group (RR, 2.7; 95% CI, 0.9-8.2). There were no significant differences in the number of doses needed, interval between first dose and delivery, incidence of contractility disturbances, or neonatal results.

CONCLUSION

The administration of misoprostol 25 mug by the sublingual route was neither more effective nor safer than the same dose administered vaginally.