Dinoprostone is More Effective than Misoprostol in Induction of Vaginal Delivery

Open Access

Abstract

Background: Induction of labour is frequently performed to reduce maternal and neonatal complications when continuation of pregnancy poses risk. Prostaglandins are widely used for cervical ripening and labour induction. Dinoprostone and misoprostol are commonly used pharmacological agents, but comparative evidence regarding their effectiveness and safety remains inconsistent. Objective: This study aimed to compare the effectiveness and safety of dinoprostone and misoprostol for induction of labour in term pregnancy. Methods & Materials: This randomized controlled trial was conducted at the Department of Obstetrics and Gynecology, Bangladesh Medical University, Dhaka, Bangladesh, from December 2024 to December 2025. A total of 250 term pregnant women requiring labour induction were randomly assigned into dinoprostone group (n=125) and misoprostol group (n=125). Primary outcomes included induction to active labour interval, induction to delivery interval, Bishop score improvement and vaginal delivery within 24 hours. Maternal and neonatal outcomes were also evaluated. Statistical analysis was performed using SPSS version 25.0. Results: Dinoprostone showed significantly shorter induction to active labour interval (11.8±4.1 vs 13.2±4.6 hours; p=0.01) and shorter induction to delivery interval (17.4±5.8 vs 19.6±6.2 hours; p=0.003). Bishop score improvement was significantly higher with dinoprostone (7.9±1.8 vs 6.8±1.9; p<0.001). Vaginal delivery within 24 hours was higher in the dinoprostone group (74.4% vs 64.0%; p=0.048). Uterine tachysystole was significantly lower in the dinoprostone group (8.8% vs 20.8%; p=0.006). Other maternal and neonatal outcomes were comparable. Conclusion: Dinoprostone is more effective than misoprostol for induction of labour, with better cervical ripening, shorter labour duration and lower uterine tachysystole.