The effectiveness of oral misoprostol compares to intravenous oxytocin in enhancing labor in primigravida: A comparative study

Background: Augmentation of labor addresses uterine inertia in primigravidae, with oxytocin being preferred. Misoprostol offers cost-effective, convenient alternatives, making it a cost-effective option.

Objective: The study evaluates the effectiveness and safety of misoprostol oral solution vs. oxytocin for primigravida augmentation.

Methodology: A randomized comparative study was conducted on primigravida in active labor in Osogbo metropolis, using three hospitals as study sites. The study included two arms: oxytocin-augmented and misoprostol-oral solution. Events in labor with fetal/maternal outcomes were monitored and documented. Appropriate statistical tests and presentations were applied, p value was set at <0.05

Result: A study of 159 patients on each arm of Oxytocin (oxy) and misoprostol (miso) was conducted, with the majority aged between 20-35 years (64.47%). The onset of adequate contractions interval was 8.73 and 9.03 minutes in Oxy and Miso arm, respectively while vaginal delivery intervals were 4.69 and 4.47 hours in the Oxy and Miso arms, respectively. Fetal Heart Rate abnormalities were more in the Miso arm but did not affect fetal outcomes. There was no significant difference in maternal outcomes, with vaginal delivery rate, caesarean section rate, postpartum hemorrhage reported estimated blood and Birth weight (p>0,005). Most neonates had a good APGAR score at birth. Stillbirth and intrauterine fetal death were not recorded. Vomiting was the only symptom with a significant more in the miso arm (p-value= 0.033),

Conclusion: Misoprostol, a 20mcg oral solution, is effective and safe for augmentation of labor in primigravidae during active labor phases, with side effects like vomiting.