Comparative study regarding effect of pH on Misoprostol in induction of labor in full term primigravida pregnant women, a double blind randomized controlled trial

Ahmed S. S. A. Rashwan 1 , Mahmoud Alalfy 2 , Mohamed el-sharkawy 1 , Abdelfatah Eldesouky 1 , Ahmed SA Ashour 1 , Ayman Hassan 1 , Alaa Alebrashy 1 , and Ahmed Bakry 1
  • 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
  • 2 Reproductive Health and Family Planning Department, National Research Centre, Aljazeerah Hospital, Giza, Egypt
Ahmed S. S. A. Rashwan
  • Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
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, Mahmoud AlalfyORCID iD: https://orcid.org/0000-0002-8429-6376, Mohamed el-sharkawy
  • Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
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, Abdelfatah Eldesouky
  • Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
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, Ahmed SA Ashour
  • Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
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, Ayman Hassan
  • Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
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, Alaa Alebrashy
  • Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
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and Ahmed Bakry
  • Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Abstract

Objectives

To evaluate the effect of altering vaginal pH on induction of labor in full-term pregnancies using Misoprostol.

Methods

This randomized controlled trial was conducted at Kasralainy Hospital, Cairo University, Egypt and Algezeera Hospital, Egypt. A total of 218 healthy term primigravida pregnant women who were scheduled for pregnancy termination were recruited in the study. The included patients were divided into three groups; Group A: Those who received normal saline vaginal wash (0.9% NaCl), Group B: those who received alkaline vaginal wash (5% sodium bicarbonate) and Group C: those who received acidic vaginal wash (5% acetic acid). Patients received 25 μg of Misoprostol E1 (Vagiprost® Adwia Pharmaceuticals, Egypt) every 6 h for a maximum of 24 h (total of four potential doses).

Results

The ‘acid’ group participants took a mean time of 20.46 h to reach active stage of labor, followed by the ‘normal saline’ group with 21.45 h and the ‘alkaline’ group with 22.59 h. The difference between the groups was statistically significant, with a p-value of 0.013.

Conclusions

Douching the vagina with acidic solution seems to supplement the effect of Misoprostol on inducing labor in full-term pregnancies, as evidenced by having the shortest mean time needed to reach active stage of labor.

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