Comparison of orally administered misoprostol and membrane sweeping for labor induction among women with singleton postdate pregnancies in South-South, Nigeria: Labor induction among women with singleton postdate pregnancies

Omonigho Esemuede; Osamudia Okhionkpamwonyi; Innocent Okoacha; Akhator Aimiehinor; Patrick Ifeanyi Okonta

doi:10.28982/josam.8097

Authors

Omonigho Esemuede Department of Obstetrics and Gynecology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria https://orcid.org/0009-0006-8280-5196
Osamudia Okhionkpamwonyi Department of Obstetrics and Gynecology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria https://orcid.org/0000-0003-0520-6836
Innocent Okoacha Department of Obstetrics and Gynecology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria https://orcid.org/0000-0002-0232-3378
Akhator Aimiehinor Department of Obstetrics and Gynecology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria https://orcid.org/0009-0007-8651-7666
Patrick Ifeanyi Okonta Department of Obstetrics and Gynecology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria https://orcid.org/0000-0001-6209-7336

DOI:

https://doi.org/10.28982/josam.8097

Keywords:

membrane sweeping, outpatient basis, oral misoprostol, postdate pregnancies

Abstract

Background/Aim: Postdate pregnancy is an indication for induction of labor to prevent post-term pregnancy with its associated complications. Labor induction processes require hospital admission, resulting in additional costs in managing patients. Therefore, safe and effective outpatient techniques that help reduce the need for inpatient induction of labor are beneficial. The aim of this study is to compare and evaluate the safety and effectiveness of two outpatient methods: a single 50 μg dose of oral misoprostol and membrane sweeping in preventing post-term pregnancy. It also examines the impact on reducing the need for hospital admission for labor induction in postdate singleton pregnancies across two tertiary hospitals in Delta State, Nigeria.

Methods: This two-center randomized controlled trial was conducted on women with uncomplicated postdate singleton pregnancies in an outpatient setting. A total of 157 participants were randomly assigned to one of two intervention groups: the oral misoprostol (OM) group or the membrane sweeping (MS) group. Participants in the OM group received a single 50 μg dose of oral misoprostol, while those in the MS group underwent a one-time membrane sweeping procedure at the antenatal clinic after 40 weeks of gestation.

Results: The participants’ baseline sociodemographic and clinical characteristics were similar in both groups. This study found that the proportion of women that achieved spontaneous onset of labor in the OM group (92.1%) was more than in the MS group (85.3%), but this difference was not statistically significant (P=0.21). This study showed that both 50 μg OM and MS are effective and safe methods for inducing labor on an outpatient basis in post-term pregnancies, with OM offering the benefits of a shorter latency period, decreased reliance for oxytocin augmentation in labor, and reduced overall labor duration (P<0.001, P=0.003 and P<0.001, respectively).

Conclusion: The study showed that both OM and MS are effective and safe outpatient agents in preventing post-term pregnancy, although the proportion of women achieving spontaneous onset of labor was greater in the OM group. The two outpatient induction methods were similar regarding neonatal outcomes and the need for Neonatal Intensive Care Unit (NICU) admission with no recorded maternal adverse effects. Both interventions demonstrated good safety profiles for outpatient care; however, a higher proportion of patients in the OM group reported a positive perception of the intervention compared to those in the MS group.

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