scholarly journals Is Unfavourable Cervix prior to Labor Induction Risk for Adverse Obstetrical Outcome in Time of Universal Ripening Agents Usage? Single Center Retrospective Observational Study

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Mlodawski Jakub ◽  
Mlodawska Marta ◽  
Galuszewska Jagoda ◽  
Glijer Kamila ◽  
Gluszek Stanislaw
Keyword(s):  
Caesarean Section ◽  
Apgar Score ◽  
Foley Catheter ◽  
Vacuum Extraction ◽  
Bishop Score ◽  
Dose Infusion ◽  
Unfavourable Cervix ◽  
Group A ◽  
Failed Induction ◽  
Group B

Cervical assessment on the Bishop scale prior to induction of labor (IOL) is one of the strongest prognostic criteria in relation to the success of the procedure. The commonly used preinduction methods are mainly aimed at reducing the percentage of cesarean sections. Our study has analyzed obstetric results of patients who had unripe cervix (Bishop score <7) before IOL and used preinduction (Foley catheter or misoprostol vaginal insert releasing 7 mcg of misoprostol per hour for 24 hours) with obstetric results of patients in whom, due to favourable cervix, only a low-dose infusion of oxytocin was used. We reviewed the medical records of 1010 single pregnancies in whom IOL was performed. We divided the patients into two groups: group A (where preinduction was used) and group B (Bishop score ≥7 points) where preinduction was not used. Patients in group A were more likely to complete the delivery by caesarean section (OR=4.58, 95% CI 3.22-6.51), and more likely to have events that were indications for operative delivery: unreassuring fetal heart rate trace (OR=3.29, 95% CI 2.07-5.23) and arrested labor or failed induction (OR=3.4, 95% CI 2.06-5.62). The groups did not differ in the percentage of vacuum extraction, postpartum haemorrhage, and meconium stained amniotic fluid. In group B, more infants were born with umbilical cord blood pH <7.1 (1.38% vs. 0%), both groups included no deliveries of newborns with Apgar score ≤3 points, the groups did not differ in terms of the percentage of newborns with Apgar score between 4 and 7 at birth (OR=0.66, 95% CI 0.29-1.49). The immature cervix and the need to use labor preinduction is a risk factor for caesarean section. The necessity of preinduction does not impair neonatological results.

scholarly journals Comparison of the efficacy, safety, acceptability and fetomaternal outcomes of combination of mifepristone and foley’s catheter with foley’s catheter alone in induction of labour in term pregnancies with previous lower segment caesarean section

2020 ◽  
Vol 9 (10) ◽  
pp. 4181
Author(s):  
Nancy Thind ◽  
Pranav Sood ◽  
Rajeev Sood ◽  
Geetika Gupta Syal
Keyword(s):  
Caesarean Section ◽  
Cervical Ripening ◽  
Combination Group ◽  
Bishop Score ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Group A ◽  
Foley’S Catheter ◽  
Failed Induction ◽  
Group B

Background: Objective of the study was to compare the efficacy, safety, acceptability, fetomaternal outcomes of combination of mifepristone and Foley’s catheter with Foley’s catheter alone in induction of labor in term pregnancies with previous Lower segment caesarean section (LSCS).Methods: This was a prospective study of 36 women induced with mifepristone and foley’s catheter and 36 women induced with foley’s catheter alone at 37 weeks to 41+6 weeks with previous LSCS.Results: Mean bishop score on admission in combined group (2.44) was comparable with that of foley’s alone group (2.91, p=0.888). Mean Bishop score (BS) after foley’s expulsion in group A and group B was 7.46 and 6.33 respectively, which was statistically significant (p<0.001). In group A 69.5% of women delivered vaginally compared to 52.2% in group B which was comparable (p=0.230). Mean induction to delivery interval was significantly short in combination group (15.5±1.3 hours versus 20.8±1.07 hours, p=0.003). 50% women in group A required oxytocin for induction/ augmentation of labour as compared to 77.8% in group B (p=0.02). Failed induction was statistically higher in group B (p<0.05). No difference was found with regards scar dehiscence, scar rupture, Postpartum hemorrhage (PPH), wound infection, puerperal pyrexia, Meconium stained liquor (MSL), fetal distress, mean birth weight, 1 and 5 minutes Appearance, pulse, grimace, activity, and respiration (APGAR) score, neonatal outcome, hospital stay.Conclusions: Priming with mifepristone before insertion of foley’s catheter results in significant change in BS signifying that combination promotes early cervical ripening as compared to foley’s catheter alone. Mifepristone plays significant role in cervical ripening, reduces induction to delivery interval, oxytocin requirement and failed induction.

scholarly journals Induction of labor in women with unfavourable cervix: comparison of efficacy of intracervical Foley catheter with PGE2 gel

2019 ◽  
Vol 8 (6) ◽  
pp. 2178
Author(s):  
Shilpa Gupta ◽  
Bhumika Kagathray
Keyword(s):  
Foley Catheter ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Patient’S Satisfaction ◽  
Unfavourable Cervix ◽  
Successful Induction ◽  
Group A ◽  
Group B

Background: The aim of our study was to compare the efficacy, safety and patient’s satisfaction of intracervical Foley catheter with intracervical dinoprostone gel (PGE2 gel) for cervical ripening for successful induction of labor.Methods: Prospective study was conducted in Department of Obstetrics and Gynaecology, M P Shah Medical College, Jamnagar, Gujarat. 317 women with term pregnancy with bishop score of less than 4 with various indications for induction were included. Intracervical foley catheter was kept in 162 women for cervical ripening (group A) while intracervical PGE2 gel was kept in rest 155 women (group B).  The change in the bishop score, progress of labor, adverse effects and outcome of labor along with the patient’s satisfaction were assessed.Results: With regard to the obstetrical parameters, the two groups were comparable with respect to maternal age, gestational age, parity, indication for induction and initial bishop score. At 12 hours, both the groups showed significant improvement in bishop score, 5.2±1.81 and 4.8±1.76 in Foley catheter and PGE2 gel respectively. Mean induction to delivery interval was 18.8±5.5 in group A and 17.9±5.3 in group B, which was statistically insignificant.  No significant differences in side effects, mode of delivery and APGAR score were noted in both the groups. However, the incidence of hyperstimulation and tachysystole was higher in PGE2 gel group.Conclusions: This study shows that both Foley catheter and dinoprostone gel appear to be equally effective agents for cervical ripening. Infect foley catheter is cheap, causes less fetal distress and is safer than PGE2 gel.

scholarly journals A comparative study of induction of preterm vaginal delivery at 20 to 28 weeks gestation in previous one lower segment caesarean section by foley catheter and prostaglandin E2 gel

2017 ◽  
Vol 6 (8) ◽  
pp. 3581
Author(s):  
Shruti Agarwal ◽  
Neelam Bharadwaj ◽  
Lata Rajoria ◽  
Indira Lamba
Keyword(s):  
Caesarean Section ◽  
Prostaglandin E2 ◽  
Foley Catheter ◽  
Induction Of Labour ◽  
P Value ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Catheter Group ◽  
Group A ◽  
Group B

Background: The aim of the study to assess the maternal outcome and safety of induced preterm vaginal birth after a previous one lower segment caesarean delivery.Methods: In this study, 100 women who had singleton pregnancies with a previous one term lower segment caesarean section, in whom induction of labour was required in between 20 to 28 wks of gestation, were included. Group A (n= 50) were induced by transcervical foley catheter and group B (n= 50) were induced by prostaglandin E2 gel and then progression of labour was monitored. Both groups were compared in terms of induction delivery interval, efficacy and safety.Results: In our study, all women were delivered vaginally and hysterotomy was not required. The mean induction delivery interval in Foley catheter group (20.180±3.3499 hrs) was significantly shorter (p-value <0.001) than PGE2 gel group B (24.050±3.6537 hrs). There was no case of uterine rupture, puerperal pyrexia, postpartum haemorrhage and uterine hyperstimulation.Conclusions: Women with previous lower segment caesarean section in whom premature induction of labour is required for any reason can be done easily, safely and effectively without maternal morbidity. Induction can be done more effectively by using transcervical foley catheter than intracervical prostaglandin E2 gel. It has shorter induction delivery interval and low complication. Hence, I suggest that every woman with previous one lower segment caesarean section who requires premature induction should go for trial of labour before repeating caesarean section.

scholarly journals Comparative study between transcervical extra-amniotic Foley’s bulb and prostaglandin E2 gel for pre-induction cervical ripening

2020 ◽  
Vol 10 (1) ◽  
pp. 119
Author(s):  
Prajakta Goswami ◽  
Kapil Annaldewar ◽  
Deepali Giri ◽  
Sachin Giri
Keyword(s):  
Prostaglandin E2 ◽  
Vaginal Delivery ◽  
Foley Catheter ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Normal Vaginal Delivery ◽  
Bishop Score ◽  
Group A ◽  
Foley’S Catheter ◽  
Group B

Background: Induction of labor is an artificial initiation of uterine activity before the spontaneous onset of labor with the aim of achieving vaginal delivery. Various pharmacological and non-pharmacological methods have been studied for the purpose.Methods: This randomized prospective study conducted in the Department of Obstetrics and Gynaecology at the Seth V. C. Gandhi & M. A. Vora Municipal General Hospital (Rajawadi Hospital), Mumbai from June 2019 to April 2020. It included pregnant patients admitted to the labor ward for induction of labor. A total 200 women were recruited and randomly allocated to the two study groups fulfilling the following selection criteria. Of these, 100 women were included in Foley's catheter group (group A) and 100 in (group B) prostaglandin E2 (PGE2) group.  Results: The subjects included mainly were of 24-28 years age group. The period of gestation was 37-42 weeks in majority of the women in both the groups. Maximum numbers of women in both groups were primigravidae, being 66% in group A and 70% in group B. Foley catheter proved to be a highly effective pre-induction ripening agent for unfavorable cervix, compared to PGE2 gel, as evident by the mean Bishop score at 12 hours (p<0.05) and by the difference in change of Bishop score over 12 hours (p<0.05) in both groups A and B. Women in both the groups had a high rate of normal vaginal delivery, rate being significantly more in Foley’s group.Conclusions: This study concludes that extra-amniotic Foley’s catheter balloon is an effective, safe, simple, low cost, reversible, non-pharmacological mechanical method of pre-induction cervical ripening.

scholarly journals INDUCTION OF LABOUR;

2014 ◽  
Vol 21 (06) ◽  
pp. 1078-1081
Author(s):  
Rabia Sajjad ◽  
Asma Ansari ◽  
Ayesha Snover
Keyword(s):  
Vaginal Delivery ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Induction Of Labour ◽  
Military Hospital ◽  
Intrauterine Death ◽  
Bishop Score ◽  
Group A ◽  
Group B

Objective: The aim of this study to justify induction of labour at 40 weeks of pregnancy in our population. Design: Quasi experimental study. Place and duration: Combined Military hospital Attock, Obstetric and Gynaecology Department from 1.6.2011 to 1.2.2012. Material and method: 100 patients were selected from outpatient department, and divided into two groups, group A, with 50 patients at 40 weeks and group B with 50 patients at 41 weeks. Booked or unbooked patients with singleton pregnancy with cephalic presentation, were selected by non propability consecutive sampling technique. Pregnancy with previous scar, medical disorder, polyhydramnios, multiple fetal and uterine abnormality and intrauterine death, placenta previa, were ruled out excluded from study. Postdate pregnancy was confirmed clinically by last menstrual period and early dating ultrasound. Patients were clinically followed for fundal height, presentations and FHR. Bishop scoring was done and patients were induced mechanically with cervical foley and vaginal pessary PGE2 according to bishop score. Amniotomy was done at bishop score more than 7. Labour was monitored with full protocol. Same procedure was repeated for group B of 50 patients who were selected according to criteria, for induction of labour at 40 weeks of pregnancy. Maternal and fetal outcome was analysed in term of mode of delivery and APGAR score respectively. Results: Out of 100 patients, 50 patients with age 20 to 35 year, presenting at 40 weeks were included in group A. Spontaneous vaginal delivery was seen in 30 patients (60%), 4 by vaccum(8%), 3 by forcep delivery (6%), 13 patients ended up into emergency LSCS (26%). In group B of 50 women, planned for induction at 41 weeks, emergency cesareans were 23 (46%). MAS was in 9(18%) babies as compared to 2% in group A and, Fetal distress (type 2 dips) were found in 3(6%) cases. Neonatal outcome was assessed with help of APGAR score. Babies delivered with good APGAR were 47 in group A, as compared to 41 in group B. Rate of vaginal delivery was high in group A (74%) induced at 40 weeks. Results were analysed by using SPSS 10 and p-value was found to 0.024. No difference was found in the incidence of fetal outcome with APGAR SCORE 10, and fewer babies were with poor APGAR SCORE and p=0.051. Conclusions: Induction at 40 weeks may reduce perinatal mortality and incidence of MAS. It does not increase risk of caesarean section when compared with induction at or beyond 41 weeks.

scholarly journals Misoprostol vs dinoprostone vaginal insert in labour induction: comparison of obstetrical outcome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jakub Mlodawski ◽  
Marta Mlodawska ◽  
Justyna Armanska ◽  
Grzegorz Swiercz ◽  
Stanisław Gluszek
Keyword(s):  
Caesarean Section ◽  
Retrospective Cohort ◽  
Clinical Status ◽  
Labour Induction ◽  
Fetal Membranes ◽  
Vacuum Extraction ◽  
Biochemical Status ◽  
Constant Rate ◽  
Unfavourable Cervix ◽  
Obstetrical Outcome

AbstractInduction of labour (IOL) is increasingly used in obstetric practice. For patients with unfavourable cervix, we are constantly looking for an optimal, in terms of effectiveness and safety, ripening of cervix protocol. It was retrospective cohort study. We analyzed obstetrical results in 481 patients undergoing IOL in one center using two different vaginal inserts that release prostaglandins at a constant rate for 24 h—misoprostol vaginal insert (MVI) with 200 µg of misoprostol (n = 367) and dinoprostone vaginal insert (DVI) with 10 mg of dinoprostone (n = 114). Full-term, single pregnancy patients with intact fetal membranes and the cervix evaluated in Bishop score ≤ 6 were included in the analysis. In the group of MVI patients, the labour ended with caesarean section more often (OR 2.71 95% CI 1.63–4.47) and more frequent unreassuring cardiotocographic trace indicating the surgical delivery occurred (OR 2.38 95% CI 1.10–5.17). We did not notice any differences in the percentage of vacuum extraction and patients in whom the use of oxytocin was necessary during labour induction. The clinical status of newborns after birth and the pH of cord blood did not differ between groups.The use of MVI 200 μg in patients with an unriped cervix is associated with a greater chance of completing delivery by caesarean section and increased chance of abnormal intrapartum CTG trace compared to the use of DVI 10 mg. These differences do not affect the clinical and biochemical status of the newborn.

scholarly journals Comparison of two different techniques of uterine closure in caesarean section: Continuous single layer technique versus Babu and Magon technique

2018 ◽  
Vol 7 (6) ◽  
pp. 2197
Author(s):  
S. Vinayachandran ◽  
Vedhapriya Sudhakar
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Single Layer ◽  
Adverse Outcomes ◽  
Caesarean Scar ◽  
Duration Of Surgery ◽  
Layer Technique ◽  
Observational Prospective Cohort Study ◽  
Group A ◽  
Group B

Background: To compare size of the caesarean scar and residual myometrial thickness (RMT) between continuous single non-interlocking and Babu and Magon technique for uterine closure following primary elective caesarean section (CS).Methods: An observational prospective cohort study was conducted at 6 weeks and 4 months postpartum following primary elective CS. Group A included 25 patients who underwent continuous single layer technique and Group B included 25 patients who underwent Babu and Magon technique for uterine closure. Baseline demographic profile, obstetric score, details of the CS and associated complications were studied. Two-dimensional Transvaginal ultrasonography (TVS) measurements of the length, width and depth of the caesarean scar and RMT were compared.Results: Mean age of study population was 29.6 years. Malpresentation (44%) was the most common indication for CS. Mean Bishops score at the time of CS was <4. The duration of surgery (-2.8 min, 37.96 ±5.660min) and estimated amount of blood loss (-51.6 ml, mean 671.20 ±136.208ml) was less in Group A compared to Group B (40.76 ±4.68min, 722.80±132.083ml respectively). The caesarean scar measurements were similar in both groups at both visits. The mean RMT in Group B at 6 weeks and 4 months postpartum (8.05mm±2.06 and 7.10mm±2.04 respectively) was statistically higher than Group A (6.23mm ± 1.76 and 5.36mm ± 1.70 respectively), p=0.002.Conclusions: We conclude that Babu and Magon technique for uterine closure in caesarean section could result in better healing of the scar and probably reduce the adverse outcomes in subsequent pregnancies.

scholarly journals Evaluation of maternal and perinatal morbidity and mortality in eclampsia by early termination of pregnancy

2020 ◽  
Vol 8 (10) ◽  
pp. 3629
Author(s):  
Suresh C. Mondal ◽  
Sandip Lahiri
Keyword(s):  
Caesarean Section ◽  
Maternal Mortality ◽  
Termination Of Pregnancy ◽  
Early Termination ◽  
Early Presentation ◽  
Neonatal Deaths ◽  
Still Births ◽  
Significant Difference ◽  
Group A ◽  
Group B

 Background: Eclampsia is one of the leading causes of maternal mortality in India.Methods: A prospective observational study was done on 200 pregnant women admitted with antepartum eclampsia in Malda Medical College from 1 April 2017 to 30 October 2019. Group A included patients who delivered through vaginal route within 10 to 12 hrs of eclampsia by stabilisation of patients while Group B included subjects who underwent early caesarean section for uncontrolled convulsions or poor Bishop score. Maternal and perinatal outcomes were compared between the groups. Data was recorded in a pretested performa and was analyzed using appropriate statistical methods with SPSS.Results: Caesarean section (group B) was done in 130 cases (65%) while vaginal delivery (group A) was done in 65 cases (37.5%). Group A had higher maternal mortality (10.7%) in comparison to group B (4.6%) which was statistically not significant (p=0.1075). There were 32 neonatal deaths (24.6%) and 11 still births (8.46%) in group A while there were 12 neonatal deaths (18.46%) and 3 still births (4.61%) in group B. There was a statistically significant difference (p<0.0001) between the groups with respect to total perinatal deaths.Conclusions: Antenatal and intranatal eclampsia should be managed by early termination of pregnancy preferably with Caesarean section. Early presentation and timely decision to terminate pregnancy will improve the maternal and perinatal outcome.

scholarly journals TO DETERMINE EFFICACY OF GRANISETRON VERSUS PLACEBO FOR REDUCING SHIVERING IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION UNDER SPINAL ANAESTHESIA

2021 ◽  
Vol 71 (2) ◽  
pp. 530-34
Author(s):  
Sana Abbas ◽  
Bilal Yasin ◽  
Basit Mehmood Khan ◽  
Umer Hayat ◽  
Beenish Abbas ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Elective Caesarean Section ◽  
Patient Comfort ◽  
Military Hospital ◽  
P Value ◽  
Intravenous Bolus ◽  
Lower Segment ◽  
Group A ◽  
Group B

Objective: To determine the efficacy of granisetron versus placebo (saline) for reducing shivering in patients undergoing lower segment caeserian section under spinal anaesthesia. Study Design: Comparative cross - sectional study. Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital Rawalpindi, from Apr to Sep 2019. Methodology: Total 178 patients undergoing lower segment ceaserian section under spinal anaesthesia with age ranges from 18-40 years of American Society of Anaesthesiologists status I & II with full term pregnancy scheduled for elective caesarean section under spinal anaesthesia. Group A (n=92) received an intravenous bolus of 1 mg granisetron in a 10ml syringe and Group B (n=86) received intravenous bolus of normal saline in a 10ml syringe, drugs were administered immediately before spinal anaesthesia by anaesthetist as coded syringes. Heart rate, blood pressure, core body temperature and shivering scores were measured at 0 minutes, 30 minutes and 60 minutes, average surgery time recorded to be 60 minutes. Results: None of the patients in group A (drug group) exhibited appreciable post spinal shivering whereas 25 (29%) in group B (placebo) had clinically significant shivering necessitated administration of other established pharmacological agents to abort shivering in order to ensure patient comfort and satisfaction with statistically significant p-value of <0.05. Conclusion: Prophylactic injection granisetron was efficacious against post spinal shivering, moreover provides worth while relief of nausea and vomiting which is dilemma with most of the drugs employed for control of post spinal shivering.

SUBLINGUAL MISOPROSTOL FOR PREVENTION OF POSTPARTUM HAEMORRHAGE – A RANDOMISED CONTROL TRIAL

2021 ◽  
pp. 56-57
Author(s):  
Anupama Anupama
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Outcome Measures ◽  
Post Partum ◽  
Randomised Control Trial ◽  
Study Group ◽  
Sublingual Misoprostol ◽  
Group A ◽  
Post Partum Haemorrhage ◽  
Group B

Aim – The aim of the study was to study the effect of sublingual misoprostol for prevention of PPH. Materials and Methods – This was a prospective, randomized, double blind, placebo controlled study. Inclusion criteria were women aged 20-40 years with 38-40 weeks of gestation who underwent elective caesarean section. Exclusion criteria were women have risk factors for post-partum haemorrhage, active thromboembolic disease and intrinsic risk for thrombosis. Participants were randomly assigned to misoprostol group or group A (n=50) and placebo group or group B(n=50). Group A received 400µg of sublingual misoprostol after delivery of the baby, group B received placebo tablet at the same time. Primary outcome measures were blood loss from delivery of the placenta to the end of the caesarean section to 2 hours postpartum, haemoglobin estimation was done in all patients pre operatively and 24 hours post operatively and the change in concentration was noted. Secondary outcome measures were need for additional uterotonics, use of additional surgical interventions to control post-partum haemorrhage. Result – Blood loss from both placental delivery to the end of caesarean section and from end of caesarean section to 2 hours postpartum were signicantly lower in the study group. (p<0.0001). Change ifn haemoglobin concentration in study group was also signicantly less than in the control group. (p<0.0001). Total amount of Oxytocin required was signicantly less in the study group (p=0.01). The number of women requiring other oxytocics (inj. Methyl ergometrine, inj. Carboprost) was signicantly less in study group (p=0.0078). Conclusion – Sublingual misoprostol has been found to be effective in preventing PPH.

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