A comparison of labor induction outcomes using a single dose of misoprostol followed by Oxytocin versus two doses of misoprostol in women undergoing labor induction at Surat thani Hospital

Abstract

Background: Induction of labor is a crucial obstetric procedure that plays a vital role in the care of pregnant women with medical indications, ensuring an appropriate and safe delivery. With the increasing rate of cesarean sections, induction of labor is essential to improving the chances of vaginal delivery. Choosing an effective and safe method is therefore necessary.

Objective: To compare vaginal delivery rates, induction time to vaginal delivery, maternal and neonatal outcomes between single-dose misoprostol combined with Oxytocin and two doses of misoprostol.

Methods: A quasi-experimental study was conducted among 104 pregnant women undergoing labor induction between April 2025 and January 2026 at Surat Thani Hospital. Participants were allocated into two groups: single-dose misoprostol with Oxytocin and two doses of misoprostol. Maternal and neonatal outcomes were compared between the groups.

Results: The combination group demonstrated a significantly higher vaginal delivery rate compared to the two doses of misoprostol group (50% vs 17.3%, P<0.001). The mean duration of labor was significantly shorter in the combination group (9.72 ± 1.92 vs 12.47 ± 3.59 hours, P<0.05). There was no statistically significant difference in postpartum hemorrhage (1.9% vs 3.8%, P=0.558), fetal heart rate abnormalities (17.3% vs 11.5%, P=0.402) and uterine rupture. (0% vs 0%).

Conclusion: Single-dose misoprostol combined with Oxytocin is more effective in increasing vaginal delivery rates and reducing labor duration compared with two doses of misoprostol, without increasing maternal or neonatal complications.