Oral and Vaginal Misoprostol for Induction of Labor in Nulliparous Pregnant Women

The aim of this study is to compare the efficacy and the safety of vaginal misoprostol with oral misoprostol for induction of labor in nulliparous pregnant women at or beyond completed 41 weeks.

Inclusion Criteria:Maternal age: 18-40.Nullipara: a woman who has never completed a pregnancy beyond 20 weeks gestation. She may not have been pregnant or may have had a spontaneous or elective abortion(s) or an ectopic pregnancy.Single living pregnancy.Gestational age: at or beyond completed 41 weeks (confirmed by a reliable date for the last menstrual period, regular cycle, or/and 1st trimesteric ultrasound scan).Cephalic presentation.Bishop score of 6 or less.Reactive fetal non-stress test (NST).Exclusion Criteria:Any maternal chronic diseases or pregnancy-induced medical disorders.Fetal anomalies.Fetal macrosomia (>4 Kg).Intrauterine Growth Restriction (IUGR) (EFW below the 10th percentile for gestational age).Rupture of membranes or oligohydramnios (AFI < the fifth percentile).Previous uterine scar.Regular uterine contractions.Any contraindication to vaginal delivery e.g., placenta previa (complete or partial covering of the internal os of the cervix with the placenta).