Comparative Study Regarding Effect Of Ph On Misoprostol In Induction Of Labor In Full Term Primigravida Pregnant Women, A Double Blind Randomized Controlled Trial

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 mu g of Misoprostol E1 (Vagiprost (R) 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.