Abstract
Objective: To compare the safety and efficacy of 25 microgram of sublingual misoprostol with 2 mg of vaginal dinoprostone for induction of labor at term.
Materials and Methods: This study was conducted in the Department of Obstetrics and Gynecology of Cantonment General Hospital, Rawalpindi. It was randomized controlled trial. All pregnant women aged 20-40, at 37-41 weeks with a live singleton fetus who required induction of labor were eligible for the study.107 patients were randomized into 2 groups. One group received 25 microgram misoprostol sublingual 4 hourly up to a maximum of four doses. The other group received 2mg dinoprostone gel vaginally 6 hourly up to a maximum of 2 doses. Both groups were compared for induction to delivery interval and number of doses which were the primary outcome measures .
Results: Induction to delivery interval was the primary outcome variable. The difference between the two groups did not reach clinical significance (p value 0.103). A larger number of women in the misoprostol group delivered within 24 hours although this difference did not reach clinical significance (p value 0.301). The other primary outcome was required number of doses. Lesser number of doses of dinoprostone were required and a larger of women in the dinoprostone group delivered with a single dose (n=29 vs 16).This was a clinically significant difference (p value 0.04). However larger number of women in the dinoprostone group required augmentation with syntocinon (p value = 0.03).
Conclusion: A 25 microgram of sublingual misoprostol has been found to be a safe and effective alternate to 2 mg of vaginal dinoprostone for induction of labor at term.

Key words: Sublingual misoprostol, dinoprostone, induction of labour. Induction to delivery interval, term pregnancy,