Comparison Between Vaginal Misoprostol Gel and Oral Misoprostol Solution in Induction of Labor

Oral Versus Vaginal Misoprostol Solution Among Pregnant Women Undergoing Induction of Labor At Ain Shams University Maternity Hospital a Randomized Controlled Trial

The goal of this clinical trial is to study the efficacy of vaginal versus oral misoprostol solution in cervical ripening for induction of labor.

The main questions it aims to answer is : is Vaginal misoprostol solution as effective as oral misoprostol solution for induction of labor? Researchers will compare oral Misoprostol Solution and vaginal misoprostol solution prepared by KY gel Participants will then be randomized into two groups using a computer-generated randomization list , the first group will receive oral solution equal to 25 microgram misoprostol every 2 hours while the second group will receive 25 microgram vaginal misoprostol solution every 4 hours The cervix will be assessed and scored at each examination. They will be reviewed before the stipulated time if they were contracting. The administration of the drugs will be discontinued when a favorable cervix is diagnosed (modified Bishop score ≥6 ) or 24 hours of study drug had been given.

Inclusion Criteria:

1. Women with a singleton pregnancy.
2. Cephalic presentation.
3. Age range: 18-40 years.
4. Gestational age between 36 and 42 weeks.
5. Intact fetal membranes.
6. Absence of spontaneous uterine contractions.
7. Non favorable cervix (Bishop score ≤ 5).
8. A reactive non stress test in case of positive fetal life.

Exclusion Criteria:

1. History of cesarean section or uterine scars
2. Grand Multipara P ≥5
3. Known fetal non-cephalic presentation
4. Any known allergy to misoprostol.
5. Multiple pregnancy
6. Contraindication to vaginal delivery.