This study will be conducted to investigate the effect of using sublingual Misoprostol and Oxytocin to induce labor on fetal electrocardiogram. In this study, pregnant women with a gestational age of 41 weeks or higher will be referred to the Midwifery Clinic meeting. Estimated sample size is 80 patients, who will be randomly in two groups; 40 cases will receive oxytocin and the other 40 receive misoprostol.
First group will receive, 50 µg sublingual misoprostol (a quarter of tablet), every 4 hours up to 4 doses; the other group, receive oxytocin infusion rate of 2 mIU/min and will be increase by 2 mIU/min in every 15 minutes. Each group will be given the placebo drug of the other group.
Inclusion criteria are: mothers desire to have vaginal delivery, gestational age of 41 weeks and above, having Bishop score below 5, normal non-stress test (NST) at birth, normal oxytocin challenge test (OCT), lack of uterine contractions. Exclusion criteria included: contraindication of misoprostol or oxytocin, fetal macrosomia, polyhydramnios, placenta previa or abruption, meconial, vaginal bleeding, intrauterine growth restriction, non-cephalic presentation, and narrow pelvis.
Exclusion criteria are: contraindication of misoprostol or oxytocin, fetal macrosomia, polyhydramnios, placenta previa or abruption, meconial, vaginal bleeding, intrauterine growth restriction, non-cephalic presentation, and narrow pelvis.
Then need for cesarean section and fetal heart rate changes will be compared between two groups.