The Use of 25 Microgram Vaginal Misoprostol for Cervical Ripening and Induction of Labour at ESUTH Parklane: A Five-Year Review (2021–2025)

Abstract

Background: Induction of labour is a key obstetric intervention aimed at improving maternal and perinatal outcomes. Misoprostol, particularly in low-dose vaginal regimens, is widely used due to its effectiveness, affordability, and stability. However, variations in clinical practice and limited long-term institutional data in low-resource settings necessitate further evaluation of its outcomes. Aim: To evaluate the effectiveness and safety of 25 microgram vaginal misoprostol for cervical ripening and induction of labour at ESUTH parklane over a five-year period. Methods: This was a retrospective descriptive study conducted at the Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital (ESUTH), Nigeria, from 2021 to 2025. A total population sampling approach was used to include 312 women who met the inclusion criteria. Data were obtained from labour ward registers, case notes, and delivery records. Variables analysed included socio-demographic and obstetric characteristics, indications for induction, induction-to-delivery interval, mode of delivery, and maternal and neonatal outcomes. Data were analysed using SPSS version 25.0, with statistical significance set at p < 0.05. Results: The majority of women were aged 20–29 years (50.0%) and multiparous (55.1%). Post-term pregnancy (33.3%) was the most common indication for induction. The overall rate of successful vaginal delivery was 73.1%, while the caesarean section rate was 26.9%. The mean induction-to-delivery interval was 16.8 ± 6.4 hours. Maternal complications were low, with uterine hyperstimulation occurring in 7.7% and postpartum haemorrhage in 5.8% of cases. Neonatal outcomes were generally favourable, with 88.5% of neonates having Apgar scores ≥7 at 5 minutes. Multiparity, favourable Bishop score, and term gestation were significantly associated with successful induction. Conclusion: Low-dose (25 µg) vaginal misoprostol is an effective and safe method for induction of labour, with high success rates and acceptable maternal and neonatal outcomes. Its affordability and ease of use make it particularly suitable for resource-limited settings.