Evaluating the Role of Dexamethasone in Improving Labour Induction Outcomes at Term | ||
| Evidence Based Women's Health Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 04 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ebwhj.2025.438676.1528 | ||
| Authors | ||
| Ahmed Samir Rashwan* 1; Nourhan Hazem2; Ashraf Eldaly3; Mazen Abdel-Rasheed4; Abdelfatah Eldesouky5 | ||
| 1Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt | ||
| 2Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt | ||
| 3Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt | ||
| 4Reproductive Health Research Department, National Research Centre, Cairo, Egypt | ||
| 5Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt | ||
| Abstract | ||
| Background: Induction of labor is a vital obstetric intervention to reduce maternal and fetal risks when pregnancy continuation is potentially harmful. Misoprostol is widely used for cervical ripening, whereas dexamethasone has recently attracted attention for its potential to enhance induction outcomes. This study evaluated the efficacy and safety of dexamethasone, alone and in combination with misoprostol, for labor induction in term pregnancies. Methods: A randomized controlled trial was conducted at Kasr Al-Ainy Hospital, Cairo University, including 150 nulliparous women at ≥39 weeks’ gestation. Participants were equally randomized into three groups: Group A received intramuscular dexamethasone sodium phosphate 8 mg, Group B received vaginal misoprostol 25 μg every 6 hours (up to four doses), and Group C received both agents. The primary outcome was the interval from induction to the active phase of labor. Secondary outcomes included duration of labor stages, mode of delivery, and neonatal outcomes assessed by NICU admission. Results: The combination group (Group C) demonstrated the shortest induction-to-active phase interval (11.9 hours) and active phase duration (6.3 hours), followed by Group B (13.9 and 7.5 hours), whereas Group A showed the longest durations (22.5 and 8.0 hours). Vaginal delivery rates were significantly higher in Groups B (70%) and C (76%) compared with Group A (10%). No significant differences were observed in second-stage duration (p = 0.739) or NICU admissions (p = 0.861). Conclusion: Combined dexamethasone–misoprostol therapy significantly improved labor induction outcomes without adverse neonatal effects. Larger multicenter trials are warranted to confirm these findings. | ||
| Keywords | ||
| Dexamethasone; Misoprostol; Labor induction; Term pregnancy | ||
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