Oral misoprostol versus vaginal dinoprostone for labor induction in nulliparous women at term

Objective:to compare the efficacy of oral misoprostol to vaginal dinoprostone for labor induction in nulliparous women.study design:admissions for labor induction from january 2008 to december 2010 were reviewed. patients receiving oral misoprostol were compared with those receiving vaginal dinoprostone. the primary outcome was time from induction agent administration to vaginal delivery. secondary outcomes included vaginal delivery within 24 h, mode of delivery and maternal and fetal outcomes.result:a total of 680 women were included: 483 (71%) received vaginal dinoprostone and 197 (29%) received oral misoprostol. women who received oral misoprostol had a shorter interval to vaginal delivery (27.2 vs 21.9 h, p<0.0001) and were more likely to deliver vaginally in <24 h (47% vs 64%, p=0.001). there was no increase in the rate of cesarean delivery or adverse maternal or neonatal outcomes.conclusion:labor induction with oral misoprostol resulted in shorter time to vaginal delivery without increased adverse outcomes in nulliparous women.