Oral Misoprostol Cuts Cesarean Risk Versus Vaginal Dinoprostone
This meta-analysis clarifies a route-specific trade-off: oral misoprostol lowers cesarean birth while vaginal dinoprostone shortens time to delivery, with comparable safety.
Oral misoprostol reduces cesarean rates compared to vaginal dinoprostone.
Labor induction is a common procedure, and understanding the optimal pharmacologic agents can improve maternal and neonatal outcomes. Oral misoprostol reduced cesarean birth rates (relative risk (RR) 0.83) and oxytocin augmentation (RR 0.89) compared to vaginal dinoprostone, which resulted in more vaginal births within 24 hours (RR 0.91) and a shorter induction-to-birth interval. Both medications showed comparable safety profiles, making oral misoprostol a viable option for selected patients, though clinical settings and population differences should be considered. Oral misoprostol may lower cesarean rates, while vaginal dinoprostone accelerates labor within 24 hours.
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Authors:Yeretsian T, Mogharbel H, Rozzah R, Ashraf R, Kirubarajan A, Thorlund K, D'Souza R
Citation:Yeretsian T, Mogharbel H, Rozzah R, et al. Oral Misoprostol Versus Vaginal Dinoprostone for Labor Induction: A Systematic Review and Meta-Analysis. The journal of obstetrics and gynaecology research. 2026;52(8):e70369. doi:10.1111/jog.70369
Subscribers receive access to a complete clinical analysis, available online and as a downloadable PDF.
Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
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