ORAL MISOPROSTOL FOR LABOUR INDUCTION OF PRIME PROBLEM RUPTURE OF MEMBRANE AT TERM
Objective: The objective of the study was to determine efficacy of oral misoprostol for induction of labour in women
with pre labour rupture of membranes at term and to monitor maternal and fetal complications.
Methodology: This is a Quasi experimental study conducted in the department of Obstetrics and Gynecology Unit A of
Mardan Medical Complex Hospital, Mardan. Patients with pre labour rupture of membranes at term were given 50 μg of
oral misoprostol after history, examination and fetal evaluation by reactive CTG. Maximum 6 doses at 4 hourly interval
were given. Misoprostol dose stopped when contractions starts. Oxytocin augmentation was done if required at least
6 hours after misoprostol. Induction-delivery interval, need for oxytocin infusion, mode of delivery, failed induction, and
maternal satisfaction were observed. Maternal complications nausea and vomiting, pyrexia, uterine hyper stimulation,
postpartum hemorrhage, uterine rupture were assessed. Meconium staining of amniotic fluid, abnormal CTG tracing,
low Apgar score at 5 minutes and still birth were observed measures to know about fetal complications.
Results: Mean induction-delivery interval were 14 hrs hours.40 patients 20% had caesarean section. Failed induction
was noted in 2 (1%) cases. Oxytocin augmentation was required in 40(20%) cases. Maternal complications were nausea
and vomiting in 30 cases (15%), pyrexia 20(10%) and hyper stimulation syndrome noted in 6 patients (3%). Fetal
complications, meconium staining of amniotic fluid was present in 40 (20%) and abnormal CTG pattern in 28 (14%),
while no baby had low Apgar score at 5 minutes and there was no still birth.
Conclusion: Oral misoprostol is safe and effective method of induction for induction of women with prelabour rupture
of membranes at term. It is associated with good maternal and fetal out come.
Key Words: Pre labour rupture of membrane (PROM) Misoprostol, induction