Comparative Study between Using Only Vaginal Misoprostol and Using Vaginal Misoprostol and Estradiol Cream for Induction of Labour: Randomized controlled trial

Abstract

OBJECTIVE: To evaluate the effectiveness of vaginal misoprostol versus vaginal misoprostol and estradiol cream for ripening of the very unfavorable cervix in patients requiring induction of labor. METHODS: This study was a randomized controlled trial conducted on 120 women with unfavorable cervix during the period from April 2021 to October 2021. Patients were randomized into two equal groups as follows; _GROUP I_ included 60 patients who were given only vaginal misoprostol 25 μg, and _GROUP II_ included 60 patients in which women were given vaginal misoprostol 25 μg with vaginal estradiol 150 mg. RESULTS: Thirty-two patients (53.3%) in the misoprostol group and 38 patients (63.3%) in the estradiol group reached the active phase. According to the mode of delivery, 29 patients (48.3%) in the misoprostol and 24 patients (40%) in the estradiol group underwent cesarean section. The most common causes of CS were failed induction and fetal distress. With exception of the 1st minute Apgar score, no statistically significant difference in labor induction between both groups was reported. CONCLUSION: We found that a combination between the misoprostol and estradiol does not achieve a significant difference in labor induction compared to vaginal misoprostol alone.