Comparison of effectiveness of oral misoprostol vs PGE2 gel in PPROM patients: A prospective study

Abstract

Preterm premature rupture of membranes (PPROM) is the spontaneous rupture of the fetal membranes before 37 weeks of gestation in the absence of regular painful uterine contractions. Active induction of labour soon after PROM reduces the risks of maternal and fetal sepsis compared with conservative management, and is associated with a shorter interval from PROM to significant uterine contractions and delivery.Materials and Methods: A prospective study was carried out in the Department of Obstetrics and Gynecology at Government Thiruvannamalai medical college, Tamil Nadu from October 2020 to October 2021. 147 PPROM patients were included in the study. Group A had 68 patients and group B had 79 patients. Group A were induced with 50µgm Misoprostol tablet and Group B were induced with 0.5 mg intracervical PGE2 gel.Results: Among 68 patients in Group A, 58(85.30%) delivered vaginally and 10(14.70%) were delivered by cesarean section. In Group B, 63(79.74%) patients delivered vaginally and 16(20.25%) were delivered by LSCS (p value 0.379). 38 patients were delivered vaginally within 12 hours in Group A whereas it was 33 in Group B. 4 required LSCS in Group A in <12 hours and 6 in Group B. In Group A LSCS was done in 6 patients after 12 hours and in Group B, LSCS was done in 10 patients after 12 hours (p valueo.400)Conclusion: Oral misoprostol 50μgm 4 hourly is safe, efficient and cost effective alternative to PGE2 gel for cervical ripening and induction of labour in PPROM patients in low resource settings.