Effect of vaginal wash before intravaginal misoprostol (pge1) insertion for induction of labour

Aim: The aim of the study is to observe the effectiveness of saline vaginal wash just before insertion of intravaginal Misoprostol for the induction of labour. Background: Saline vaginal wash removes the secretions of the vagina, enhances the bioavailability of Misoprostol. Prostaglandin E1 analogue has dual role for cervical ripening and induction and initiation of labour. Methods: A prospective randomized control trail conducted with 2 groups of pregnant women at term with and without saline vaginal wash before insertion of intpra vaginal Misoprostol. Cases consisted of 50 pregnant women with vaginal wash before intra vaginal Misoprostol. Controls consisted of 50 pregnant women with no vaginal wash before Misoprostol insertion. Results: The total number of pregnant women 100 divided in to two groups has similar mean age, body mass index, gestational age, gravidity, parity and Bishop score before drug insertion. Time, frequency and number of doses of Misoprostol kept intravaginally, time from the beginning of Misoprostol 25mcg insert vaginally to the active phase of labour and time of the delivery were significantly longer in the control group (p<0.05). Conclusion: Simple easy method with good outcome without or minimal side effects. Results of our study are comparable to other studies with saline wash before insertion of Misoprostol . So can be considered as routine practice. Limitations of our study are vaginal pH is not estimated and vaginal cultures are not done before and after saline vaginal wash.