0.5mg Dinoprostone is used almost exclusively for pre-labour ripening of the cervix at-term in Greece. The ob/gyns that use misoprostol usually use 25μg Misoprostol and they repeat after 6 hrs if the Bishop Score is less than 6.

we also use 25micro gram, however, manytimes we use 50micro gram in primiparous women every 6 hours if the Bishop score is less than 6.

MH MODIBBO Murtala Muhd Specialist Hospital, Kano (MMSH)

At MMSH, we use 25 micrograms 6 hourly, if the Bishop Score is < 6.

In my particular Hospital urgency team we use 50micrograms orally (not vaginal nor sublingual) if there is a bad bishop score (

What are the advantages/disadvantages of using Misoprostol for ripening cervix at term by one route over the other?

is not PG E2 is better choice than misoprostol?????

Current ACOG guidelines, research, and clinical practice seem to indicate that misoprostol (25-mcg dosing vaginal regimens) is a safe, effective, cheaper, and easier alternative to dinoprostone and should be considered for use for labor induction at term in women who do not have a specific risk for uterine rupture.

I am not sure there is a better choice. Use the regiment u feel comfortable with and always follow quidelines

My experience shows, for ripening of cervix mechanical methods are best. and for induction of labour Misoprostal is best . If we give misoprost for an unripe cervix, there is more chances of meconium stained liquor.

My experience shows, for ripening of unfavourable cervix dinoprostone gel is better than misoprostal. Because of chances of meconium staining. once the score improves single dose of Miso 25mcg vaginally is very good . Each case is different so I decide after cervical scoring.

Intravaginal

We and a handful of other Swedish hospitals use 25 ug oral misoprostol every 2nd hour up to 8 administrations if needed, until painful contractions. One tablet of 200 ug is dissolved in 20 ml of tap water, and 2.5 ml (25 ug) is self-administered using an oral syringe. This has lowered CS rate in this group from 30 to 27% with less discomfort from repeated vaginal exams for the birthing women. CTG is registered for around 20 mins before each dose. Vaginal exam is only performed to confirm active phase or after these 8 doses to decide on the method to continue the induction.

50 Micro x 3 daily.