Oral or vaginal misoprostol better methods oxytocin for labour induction in pregnant women

Oral/vaginal misoprostol is a better method than oxytocin for labour induction, states a recent study published in the European Journal of Obstetrics & Gynecology and Reproductive Biology.

The updated systematic review and meta-analysis of RCTs revealed that compared with oxytocin, the administration of vaginal misoprostol led to a significant increase in the rate of vaginal delivery and Tachysystole risk and a significant reduction in the rate of cesarean. Oral misoprostol was tied to a significant reduction in cesarean rate and a significant rise in the hypertonicity risk but had no significant effect on vaginal delivery versus oxytocin.

For this purpose, the researchers conducted a systematic search of online databases up to April 2023 to identify articles investigating the effect of oxytocin and oral/vaginal misoprostol on delivery outcomes including neonatal and maternal outcomes. A total of 45 RCTs comprising 8406 participants were included.

Vaginal misoprostol administration, compared with oxytocin, resulted in a significant reduction in the rate of cesarean and a significant increase in the rate of vaginal delivery and Tachysystole risk.

Oral misoprostol was associated with a significant reduction in the rate of cesarean and a significant increase in the risk of hypertonicity compared with oxytocin.

Oral misoprostol had no significant effect on vaginal delivery compared with oxytocin.

"The findings showed that vaginal misoprostol increased vaginal deliveries but raised the risk of Tachysystole and reduced cesarean rates," the researchers wrote. "Oral misoprostol reduced cesarean rates and increased the hypertonicity risk compared to oxytocin."

Reference: Ameri, A., Jafari-Azar, Z., Anabi, M., & Dolatabadi, M. D. (2023). Effect of misoprostol versus oxytocin on delivery outcomes after labour induction in pregnant women: A systematic review and meta-analysis of randomized controlled trials. European Journal of Obstetrics & Gynecology and Reproductive Biology. https://doi.org/10.1016/j.ejogrb.2023.11.006