Vaginal Versus Sublingual Misoprostol for Labor Induction at Term and Post Term: a Randomized Prospective Study

Document Type : Research article


1 Associated professor of Obstetrics and Gynecology, Women's Health Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Obstetrics Gynecologist, Mashhad University of Medical Sciences, Mashhad, Iran.

3 General Practitioner, Mashhad University of Medical Sciences, Cardio-Vascular Research Center, Mashhad, Iran.

4 Associated professor of Department of Medicosocial, Biostatics Unit, Mashhad University of Medical Sciences, Mashhad, Iran.


We want to compare the efficacy and safety of vaginal versus sublingual misoprostol for cervical ripening and induction of labor. This randomized clinical trial was performed on 140 women with medical or obstetric indications for labor induction. The patients were randomly divided into two groups: vaginal and sublingual administration of misoprostol. In first group, 25 µg misoprostol was placed in the posterior fornix of the vagina and second group received 25 µg misoprostol sublingually, every 6 hours for 24 h. Maternal and neonatal outcomes were analyzed. There was no significant difference in the demographic characteristics between two groups. The main indication for cesarean section in both groups was fetal distress, followed by absence of active labor progress. Evaluation of cesarean indication was not significantly different in two groups; including fetal distress, absence of active labor, uterine over activity and failure to progress. The maternal complication in sublingual group included residual placenta (2%), tachysystole (2%), vomiting (12%), atoni (3.3%) and abdominal pain (5.5%), although there was no significant difference between two groups. Sublingual misoprostol is as effective as vaginal misoprostol for induction of labor at term. However, sublingual misoprostol has the advantage of easy administration and may be more suitable than vaginal misoprostol.


Main Subjects