Preinduction cervical ripening: A randomized prospective comparison of the efficacy and safety of intravaginal and intracervical prostaglandin E2 gel

1997 ◽  
Vol 176 (6) ◽  
pp. 1305-1312 ◽  
Author(s):  
James E. Stempel ◽  
Robert P. Prins ◽  
Susan Dean
2017 ◽  
Vol 24 (02) ◽  
pp. 288-292
Author(s):  
Raheela Baloch ◽  
Nigar Jabeen ◽  
Sana Zahiruddin ◽  
Ms. Kiran Mawani

Efficacy and safety of intra-vaginal prostaglandin E2 pessary for induction ofLabor. Objectives: To evaluate the efficacy and safety of intra-vaginal prostaglandin E2 pessaryfor induction of Labor. Study Design: Case control study. Setting: Gynecological and obstetricward of Liaquat University of Medical and Health Sciences Hospital, Hyderabad. Period: 14 Feb2012 to 13 Feb 2013. Study Population: All the Pregnant women at term or post term admittedin gynae ward from 14th February 2012 to 13th February 2013. Results: 100 women recruitedin the study, study carried out at Gynecological ward of Liaquat University of Medical and HealthSciences Hospital Hyderabad. Analysis of booking status listed in Table-I revealed that 68% (n= 68) were un-booked having no antenatal care and 32.0% (n = 32) were booked. There wereno protocol violation, relation to the parity listed in Table-II showed maximum number of patients(n = 62) 62.0% Primigravida and (n = 38) 38.0% multigravidas were include. Age distributionis listed in Table-III maximum patients (n = 49) 49.0% at age between 26 - 35 years, 35 (35.0%)were between 20 - 25 years, 10 (10.0%) were >35 years and 06 (6.0%) patients were belong toless than 20 years. Regarding the gestational age 57 (57.0%) patients in our study presentedbetween 37 - 39 weeks of gestation. However, 47 (47.0%) patients were at 40 - >40 weeksof gestation showed in the (Table-IV). Indication for cervical ripening and induction of laboris listed on Table-V commonest indication was pregnancy induced hypertension followed byprolonged pregnancy, and IUGR etc. Table-VI shows the Bishop score 30 (30.0%) had BishopScore 2 – 3, while 70(70.00%) had a bishop score 4-5. Table-VII shows induction-deliveryinterval, Greater number of women (66/100) delivered within 24 hours of start of induction.Table-VIII showed mode of delivery, majority of the women had normal vaginal deliveries 64.00while 16 deliveries by assisted vaginal deliveries while in remaining 20 cases caesarean sectiondone. Table-IX shows four babies had an Apgar score 4/10 at end of 1 min and 7/10 at end of5 min, whereas 96 babies had an Apgar score of 9/10 in 1 min. The indications for caesareansection are shown in Table-X. There were 09(9%) cases of failed induction, 11 cases of a fetaldistress (Meconium stained liquor). There was no increased incidence of neonatal sepsis orChorioamniotis or puerperal sepsis in any of our patients. No perinatal morbidity or mortalityor any severe maternal complications were noted while mild side effects were noted which ismentioned in (Table-XI). Conclusion: In developed countries prostaglandin E2 are widely usedfor ripening of unfavorable cervix in induction of labor but patient response vomiting, diarrhea,tachycardia, and fever are commonly observed minor side effects. Induction with Prostaglandinreduced the rate of pregnancies progressing beyond 41 weeks and related feto-maternalmorbidity and mortality. After excluding contra indication all women should be offered inductionat 41 completed weeks. Induction with prostaglandin with medical disorder like preeclampsia issafe and better feto maternal outcome.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Moti Gulersen ◽  
Cristina Zottola ◽  
Xueying Li ◽  
David Krantz ◽  
Mariella DiSturco ◽  
...  

Abstract Objectives To assess the risk of chorioamnionitis in nulliparous, term, singleton, vertex (NTSV) pregnancies with premature rupture of membranes (PROM) and an unfavorable cervix undergoing labor induction with either prostaglandin E2 (PGE2) or oxytocin only. Methods Retrospective cohort of NTSV pregnancies presenting with PROM who underwent labor induction with either PGE2 (n=94) or oxytocin (n=181) between October 2015 and March 2019. The primary outcome of chorioamnionitis was compared between the two groups. Statistical analysis included Chi-squared and Wilcoxon rank-sum tests, as well as logistic regression. For time to delivery, a Cox proportional hazard regression was used to determine the hazard ratio (HR) and adjusted HR (aHR). Results Baseline characteristics were similar between the two groups. Cervical ripening with PGE2 was associated with an increased rate of chorioamnionitis (18.1 vs. 6.1%; aOR 4.14, p=0.001), increased neonatal intensive care unit admissions (20.2 vs. 9.9%; aOR 2.4, p=0.02), longer time interval from PROM to delivery (24.4 vs. 17.9 h; aHR 0.56, p=<0.0001), and lower incidence of meconium (7.4 vs. 14.4%; aOR 0.26, p=0.01), compared to the oxytocin group. Conclusions Based on our data, the use of oxytocin appears both superior and safer compared to PGE2 in NTSV pregnancies with PROM undergoing labor induction.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Peng ◽  
Ruobing Li ◽  
Shuguo Du ◽  
Heng Yin ◽  
Min Li ◽  
...  

Abstract Background This study aims to evaluate the efficacy and safety of the induction of labour in mid-trimester pregnancy using a double-balloon catheter (DBC) within 12 h versus within 12–24 h. Methods In this retrospective study, a total of 58 pregnant women at 14 + 0 weeks to 27 + 6 weeks of gestation were enrolled as research subjects, and they underwent the intended termination of pregnancy at our birth centre from January 1, 2017, to June 31, 2019. Based on the duration of DBC, the patients were divided into two groups, namely, the DBC group within 12 h and the DBC group within 12–24 h. Results All 58 cases were successful vaginal deliveries, and no one chose to undergo caesarean section. The success rate of induction (successful abortion of the foetus and placenta without the implementation of dilation and evacuation) was higher in the DBC group within 12–24 h (96.3%, 29/31) than in the DBC group within 12 h (71.0%, 18/27) (p < 0.05). Additionally, the time from DBC removal to delivery in the DBC group within 12–24 h was significantly shorter than that in the DBC group within 12 h (3.0 h versus 17.8 h) (p < 0.05), and the degree of cervical dilation after DBC removal in the DBC group within 12–24 h was larger than that in the DBC group within 12 h (p < 0.05). Conclusion In the clinic, the placement time of DBC generally lasts for approximately 12 h. However, considering that the cervical condition is immature in the mid-trimester, properly extending the placement time of DBC to 24 h will benefit cervical ripening and reduce the chance of dilation and evacuation.


KYAMC Journal ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 668-672 ◽  
Author(s):  
Sohana Siddique ◽  
Muhammad Jahangir Howlader ◽  
Joysree Saha ◽  
Kazi Shahnaz Begum

Objective: To compare efficacy and safety of oral misoprostol over vaginal misoprostol for labour induction.Materials and Methods: This is a cross sectional interventional hospital based comparative study which was carried in the department of Obstetrics and Gynecology in DMCH from 01.07.2008 to 31.12.2008.Results: Almost equal number of patients delivered vaginally spontaneously in both group, there is no association between route of administration and mode of delivery. Nausea,vomiting occurred more in oral group and uterine hypertonicity more in vaginal group.Conclusion: In this study, 50 patients were randomly selected for oral group and 50 patients for vaginal group. There were no significant differences regarding age, duration of pregnancy, Bishop's score and indication of induction of labour.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 668-672


BMJ ◽  
1977 ◽  
Vol 2 (6099) ◽  
pp. 1381-1384 ◽  
Author(s):  
I Z MacKenzie ◽  
M P Embrey

Author(s):  
Ylva M. Stjernholm ◽  
Lena Sahlin ◽  
Håkan A. Eriksson ◽  
Birgitta E. Byström ◽  
Per-Mårten Stenlund ◽  
...  

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