## Prostaglandin Analogues in Labor Induction **Key Point:** Misoprostol is the most widely used prostaglandin analogue for cervical ripening and labor induction globally and in India due to its stability, low cost, and ease of administration. ### Comparison of Prostaglandins | Agent | Type | Route | Stability | Cost | Use in India | |-------|------|-------|-----------|------|---------------| | Misoprostol | PGE1 analogue | Oral, vaginal, sublingual | Stable at room temperature | Very low | Most common | | Dinoprostone | PGE2 | Vaginal gel, insert | Requires refrigeration | High | Limited use | | Carboprost | 15-methyl PGF2α | IM injection | Stable | Moderate | Reserved for postpartum hemorrhage | | Sulprostone | PGE1 analogue | IV/IM | Requires refrigeration | High | Not commonly used | **High-Yield:** Misoprostol dosing for cervical ripening: 25 μg vaginally every 3–6 hours (maximum 6 doses in 24 hours) or 25 μg orally every 2 hours. **Clinical Pearl:** Misoprostol is preferred in resource-limited settings because it does not require refrigeration, is inexpensive, and can be administered vaginally, orally, or sublingually. **Warning:** Carboprost causes systemic side effects (fever, hypertension, bronchospasm) and is NOT used for cervical ripening—it is reserved for management of postpartum hemorrhage refractory to oxytocin. ### Why Misoprostol? 1. Stable at room temperature (no cold chain required) 2. Multiple routes of administration 3. Cost-effective 4. Effective cervical ripening in 12–24 hours 5. Acceptable safety profile when used appropriately
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.