scholarly journals Intravaginal rings for continuous low-dose administration of cervical ripening agents

2018 ◽  
Vol 549 (1-2) ◽  
pp. 124-132 ◽  
Author(s):  
Yujing Wang ◽  
Peter Boyd ◽  
Alyson Hunter ◽  
R. Karl Malcolm
2020 ◽  
Vol 222 (1) ◽  
pp. S201
Author(s):  
Arthurine Zakama ◽  
Nasim Sobhani ◽  
Melissa G. Rosenstein ◽  
Robyn Lamar
Keyword(s):  
Low Dose ◽  

Author(s):  
Alka N. Nadar ◽  
Sirisha P. S. R. N. S.

Background: Active induction of labour in prelabour rupture of membranes resulted in a lower risk of maternal and fetal sepsis as compared to conservative management. Pre-induction cervical ripening helps in successful induction of labour.in this study we have compared the efficacy of low dose 25 mcg oral misoprostol versus intracervical PGE2 gel for cervical ripening in term PROM patients.Methods: Women with pregnancies between 37 and 41 weeks gestational age presenting with PROM at term and a Bishop score of 4 or less were randomly assigned to receive either a 25-mcg oral misoprostol every 4-hourly interval or 3 applications of intracervical PGE2 gel at a 6-hour interval for effective cervical ripening. Oxytocin was initiated if labor had not started after 6 hours of last effective dose of prostaglandin.Results: Fifty-three women (75.73%) (n = 70) in the oral misoprostol group with 2 doses, 4 hours apart had successful cervical ripening within 8 hours in comparison to sixty-two women (88.58%) (n = 70) in the intracervical PGE2 gel group with 2 doses, 6 hrs apart approximately 12 hrs for successful ripening. (p = 0.021). Oral misoprostol group needed shorter mean duration interval for the Bishop score <4 to >6 than intracervical PGE2 gel group, 7.84±3.64 hours and 9.39±4.20 hours respectively (p = 0.022). Similarly, the mean time duration interval from ruptured membranes to vaginal delivery in oral misoprostol was shorter i.e. 12.60±3.78 hours versus 14.66±4.08 hours (p = 0.005).Conclusions: Low dose 25 mcg oral misoprostol is a safe, efficacious and better tolerated alternative to intracervical PGE2 gel for pre-induction cervical ripening in especially in PROM patients at term.


2011 ◽  
Vol 133 (02) ◽  
pp. 23-26 ◽  
Author(s):  
Alessandro Grattoni ◽  
Scott Parazynski ◽  
Fazle Hussain

This article discusses the development of highly structured membranes for constant release of therapeutics over a broad range of molecular sizes, at release rates relevant for medical applications. In the experimental study, the constant release was achieved with small molecules such as leuprolide, a common treatment for prostate cancer, as well as with large molecules such as bevacizumab, widely used in the treatment of metastatic colon cancer. Such an approach could be applied to achieve the goal of metronomic delivery of chemotherapeutics, a constant low-dose administration of drugs over a long period of time. By exploiting nanochannels in passive systems, researchers were to achieve a controlled and constant delivery for extended periods of time, mimicking the basal and continuous flow of molecules from natural glands. This functionality cannot be attained at the macro- or microscale without the use of complex pumping devices and other moving components, because the diffusion of molecules is Fickian, meaning that the release rate is dictated by the gradient of molecular concentration.


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