A Comparative Study between PGE 1 and PGE 2 for Induction of Labour

Background: Induction of labour is a common obstetric intervention, and its success depends largely on cervical favourability. Prostaglandin E₁ (misoprostol) and prostaglandin E₂ (dinoprostone) are both widely used for cervical ripening, but evidence on their relative efficacy and safety in Indian tertiary care settings remains inconsistent.

Objective: To compare the efficacy and safety of PGE₁ and PGE₂ for induction of labour in term pregnant women with an unfavourable cervix.

Methods: This hospital-based prospective comparative study was conducted in the Department of Obstetrics and Gynaecology, Maharani Laxmi Bai Medical College, Jhansi, from May 2025 to April 2026. A total of 166 women at term (37–42 weeks) with singleton cephalic pregnancies and Bishop score ≤6 were randomly allocated to receive PGE₁ (n=83) or PGE₂ (n=83). Change in Bishop score, induction-to-delivery interval, mode of delivery, oxytocin requirement, maternal complications, and neonatal outcomes were compared using SPSS 25.0; p<0.05 was considered significant.

Results: Baseline characteristics were comparable. Post-induction Bishop score was higher with PGE₂ (7.2±1.5 vs 6.4±1.6; p=0.01), whereas the induction-to-delivery interval was shorter with PGE₁ (15.2±4.5 vs 18.1±5.2 hours; p=0.001). Oxytocin augmentation (61.4% vs 42.1%; p=0.01) and uterine hyperstimulation (14.5% vs 4.8%; p=0.03) were more frequent with PGE₁. Caesarean rates (31.3% vs 28.9%; p=0.75), Apgar scores, and NICU admissions did not differ significantly.

Conclusion: Both agents are effective and safe. Misoprostol achieves faster delivery, while dinoprostone offers superior cervical ripening with fewer maternal side effects; selection should be individualised to patient profile and institutional resources.