scholarly journals Labor induction with randomized comparison of cervical, oral and intravaginal misoprostol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masoumeh Dadashaliha ◽  
Somayeh Fallah ◽  
Monirsadat Mirzadeh
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Active Phase ◽  
Study Groups ◽  
Induction Of Labor ◽  
Significance Level ◽  
Medical Interventions ◽  
Routes Of Administration ◽  
Link Type ◽  
Unfavorable Cervix

Abstract Background This study attempts to evaluate the safety and effectiveness of 50μgm intracervical misoprostol in comparison with intravaginal and sublingual for the induction of labor at term pregnant women. Methods This study is designed as a parallel clinical trial study. Three hundred and fifteen term pregnancies requiring induction of labor were treated with the maximum used misoprostol intracervical, sublingual, and vaginal doses. Participants were randomly allocated into three groups of 105. The dose was repeated every 4 h until adequate uterine contraction and Bishop Score were achieved. The duration of induction to births, time to the active phase, the rate of births, and the need for caesarean section were compared in three groups. Additionally, labor course and side effects were recorded and analyzed. Data were analyzed using SPSS software. A significance level of p <  0.05 was considered for statistical analyses. Findings Labor was successfully induced in all cases most (63%) of which required a single dose of misoprostol. Ninety-three (93.0%, p <  0.05) cervical participants proceeded to vaginal births. This figure was also the same in the vaginal and sublingual group of 83 cases (83.0%). The other 41 cases received caesarean section with more indications of failure to progress and meconium-stained liquor. The results indicated that 278 (92.7%) births were achieved in less than 10 h. Time from start of medication to the active phase of labor and childbirth was 3.01 ± 0.86 and 6.1 ± 1.3 h in the Cervical group, 4.2 ± 0.66 and 8.4 ± 0.92 h in the sublingual group, and 5.06 ± 1.1 and 9.2 ± 1.5 h in the vaginal group respectively (p < 0.001). The Caesarean rate was lower in the cervical group than in the two other groups (p = 0.05). No significant differences were observed between the study groups in terms of Apgar score and meconium-stained amniotic fluid. Furthermore, no maternal and neonatal complications were observed. Conclusion In addition to the sublingual and intravaginal routes of administration, intracervical misoprostol at a single dose of 50μgm appears to be an effective method for induction of labor in women with an unfavorable cervix. Like all medical interventions, a discussion of the risks, benefits, and alternatives to induction of labor with this medication in each woman should be undertaken before treatment. Trial registration This clinical study was approved by the Iranian Registry of Clinical Trials with IRCT ID: IRCT20190415043278N1. Registration date was on May 13, 2019 and May 27, 2019 respectively (http://www.irct.ir).

scholarly journals Cervical Versus Vaginal, and Sublingual Misoprostol for Labor Induction at Term Parturient: a Randomized Double-blind Clinical Trial

2021 ◽  
Author(s):  
Mahtab Dadashaliha ◽  
Somayeh Fallah ◽  
Monirsadat Mirzadeh
Keyword(s):  
Single Dose ◽  
Active Phase ◽  
Study Groups ◽  
Induction Of Labor ◽  
Double Blind ◽  
Medical Interventions ◽  
Routes Of Administration ◽  
Double Blind Clinical Trial ◽  
Sublingual Misoprostol ◽  
Individual Woman

Abstract Background: The study will attempt to evaluate the safety and effectiveness of intracervical misoprostol in comparison with intravaginal and sublingual for the induction of labor at term. Methods: three hundred term pregnancies requiring induction of labor were treated with 50μg of misoprostol intracervical, sublingual and vaginal. Participants were randomly allocated into three groups of 100. The dose was repeated every 4 hours until adequate uterine contraction and Bishop score were achieved. The duration of induction to delivery, time to active phase, the rate of delivery, and the need for cesarean section were compared in three groups. Additionally, labor course and side effects were recorded and analyzed.Results: Labor was successfully induced in all cases, most (63%) of which required a single dose of misoprostol. Ninety-three (93.0%) cervical patients proceeded to spontaneous vaginal delivery, also this figure was the same in the vaginal and sublingual group 83 (83.0%), The other 41 cases received cesarean delivery with more indications failure to progress and meconium-stained liquor. The results showed that 278 (92.7%) deliveries were achieved in less than 10 hours. Time from start of medication to the active phase of labor and delivery were 3.01 ± 0.86 and 6.1 ± 1.3 hours in the Cervical group, 4.2 ± 0.66 and 8.4 ± 0.92 hours in the sublingual group, and 5.06 ± 1.1 and 9.2 ± 1.5 hours in the vaginal group respectively (p<0.001). Cesarean rate was lower in the cervical group than the two other groups (p=0.05). No significant differences were observed between the study groups in terms of Apgar score and meconium-stained amniotic fluid. Moreover, no maternal and neonatal complication were seen.Conclusion: In addition to the sublingual and intravaginal routes of administration, intracervical misoprostol at a single dose of 50μg appears to be an effective method for induction of labor in women with an unfavorable cervix. Similar to all medical interventions, a discussion of the risks, benefits, and alternatives to induction of labor with this medication in each individual woman should be undertaken prior to treatment. Trial registration: This clinical study was approved by the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT20190415043278N1, Registration and approval date was 2019-05-13 and 2019-05-27 respectively.

scholarly journals Effectiveness of dinoprostone vaginal pessary in induction of labour at term

2017 ◽  
Vol 6 (12) ◽  
pp. 5528
Author(s):  
Devdatt L. Pitale
Keyword(s):  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Active Phase ◽  
Induction Of Labor ◽  
Induction Of Labour ◽  
Maternal Anxiety ◽  
Untoward Event ◽  
Vaginal Pessary ◽  
Structural Network ◽  
Unfavorable Cervix

Background: Induction of labour is a very common obstetric procedure worldwide. The ultimate goal of induction of labour is to achieve a successful vaginal delivery. Dinoprostone is a Prostaglandin (PGE2) which acts on the collagen structural network of the cervix and makes it favourable, thus increasing the chances of a successful of a vaginal delivery. This study emphasizes on the importance of having a proper induction protocol in place and at the same time judicious use of the agents for induction of labour. This will help to reduce the maternal anxiety and stress associated with the induction of labour. The present study was undertaken to assess the effectiveness of dinoprostone vaginal pessary in induction of labour at term.Methods: Twenty patients with unfavorable cervix at term were studied for the effectiveness of Dinoprostone vaginal pessary in induction of labor.Results: Among the twenty patients 17 (85%) delivered vaginally within 18 hrs and 3 (15%) were in the active phase of labour. No untoward event was observed in any of the cases with a favorable neonatal outcome in all the cases.Conclusions: Present study shows that Dinoprostone vaginal pessary is a highly effective method of induction of labor at term in properly selected cases. It reduces consistently the number of internal examinations and thus reducing the risk of ascending infections adding to it's safety along with reduced maternal anxiety associated with induction of labour.

Employing Gamma Ray Irradiated Giardia lamblia as Trialed Vaccine in Experimental Animal

2019 ◽  
Vol 9 (02) ◽  
Author(s):  
Amal Kamil Abdul Sada ◽  
Amany Mohamed Al-Kaysi
Keyword(s):  
Giardia Lamblia ◽  
Gamma Ray ◽  
Age Groups ◽  
Active Phase ◽  
Study Groups ◽  
Negative Control ◽  
Control Group ◽  
High Dose ◽  
Histopathological Changes ◽  
Gamma Irradiated

This is an experimental trial to prepare a vaccine from gamma-irradiated Giardia lamblia which is evaluated in experimental animals. The study was conducted from December 2015 to April 2016. The field survey of the parasite was conducted from those patients attending the laboratories of the Alawi Children's Hospital in Rusafa and the Al-Yarmouk Teaching Hospital in Karkh, through which 1250 stool samples of different age groups were examined. Five groups of mice were used in the study; the first was injected with normal saline and considered as a negative control group, the second was injected with cystic form of non-irradiated Giardia lamblia and considered as a positive control group, whereas the other three groups were injected with gamma irradiated Giardia lamblia at three different doses 10, 15 and 25 rad respectively. Giardia lamblia was primarily cultivated in liver infusion agar for ten days to obtain the active phase. On the sixth day, the cystic phase was purified and standardized to be used in the infection of mice with or without the exposure of gamma rays. Mice showed high sensitivity to parasitic infestation, in the gamma non-irradiated and the irradiated with gamma 10 rad, and 15 rad irradiated groups which was 100%. The results expressed an excystation process of the depleted phases and the release of the feeder phases. The results of the three irradiated groups consisted of histopathological changes of the small, and the rectum by dissection after two weeks of infection, with intestine amputation lesions, as well as ulceration and inflammation of the inflammatory cells represented in small numbers of neutrophil, lymphocytes, and eosinophils. The presence of ulceration and fall of epithelial cells in the intestinal cavity has been shown, and different forms of the parasite have been observed. Mice which was injected with irradiated G lamblia at high dose (25 rad), not show and sensitivity to the challenge infection and no excystation of thy parasite had been done. After 2 wreaks, a comparison was achieved between all study groups in which no histopathological changes were noticed in the mice irradiated with dose of25 rad. After another two weeks, a challenge dose was given (un-attenuated G lamblia) and mice were dissected after another two weeks, no changes on the level of histopathology of intestinal tissue were noticed the results suggested that mice acquire an immunity against the parasite infection.

scholarly journals Continued versus discontinued oxytocin stimulation in the active phase of labour (CONDISOX): double blind randomised controlled trial

BMJ ◽  
2021 ◽  
pp. n716
Author(s):  
Sidsel Boie ◽  
Julie Glavind ◽  
Niels Uldbjerg ◽  
Philip J Steer ◽  
Pinar Bor
Keyword(s):  
Caesarean Section ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Controlled Trial ◽  
Caesarean Section Rate ◽  
Active Phase ◽  
Double Blind ◽  
Oxytocin Infusion ◽  
Randomised Controlled ◽  
Reduced Risk

Abstract Objective To determine whether discontinuing oxytocin stimulation in the active phase of induced labour is associated with lower caesarean section rates. Design International multicentre, double blind, randomised controlled trial. Setting Nine hospitals in Denmark and one in the Netherlands between 8 April 2016 and 30 June 2020. Participants 1200 women stimulated with intravenous oxytocin infusion during the latent phase of induced labour. Intervention Women were randomly assigned to have their oxytocin stimulation discontinued or continued in the active phase of labour. Main outcome measure Delivery by caesarean section. Results A total of 607 women were assigned to discontinuation and 593 to continuation of the oxytocin infusion. The rates of caesarean section were 16.6% (n=101) in the discontinued group and 14.2% (n=84) in the continued group (relative risk 1.17, 95% confidence interval 0.90 to 1.53). In 94 parous women with no previous caesarean section, the caesarean section rate was 7.5% (11/147) in the discontinued group and 0.6% (1/155) in the continued group (relative risk 11.6, 1.15 to 88.7). Discontinuation was associated with longer duration of labour (median from randomisation to delivery 282 v 201 min; P<0.001), a reduced risk of hyperstimulation (20/546 (3.7%) v 70/541 (12.9%); P<0.001), and a reduced risk of fetal heart rate abnormalities (153/548 (27.9%) v 219/537 (40.8%); P<0.001) but rates of other adverse maternal and neonatal outcomes were similar between groups. Conclusions In a setting where monitoring of the fetal condition and the uterine contractions can be guaranteed, routine discontinuation of oxytocin stimulation may lead to a small increase in caesarean section rate but a significantly reduced risk of uterine hyperstimulation and abnormal fetal heart rate patterns. Trial registration ClinicalTrials.gov NCT02553226 .

scholarly journals Comparing the efficacy and side-effects of PDLASTA® (Pegfilgrastim) with PDGRASTIM® (Filgrastim) in breast cancer patients: a non-inferiority randomized clinical trial

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Safa Najafi ◽  
Maryam Ansari ◽  
Vahid Kaveh ◽  
Shahpar Haghighat
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Single Dose ◽  
Side Effects ◽  
Randomized Clinical Trial ◽  
Cancer Patients ◽  
Injection Site Reaction ◽  
Study Groups ◽  
Breast Cancer Patients ◽  
Significant Difference

Abstract Background The objective of this study was to compare the efficacy and side effects of a single dose (Pegfilgrastim or PDL) or repeated six daily injections (Filgrastim or PDG) during chemotherapy courses in breast cancer patients in a non-inferiority clinical trial. Methods In this randomized clinical trial, 80 patients were recruited and allocated randomly to two equal arms. In one group, a single subcutaneous dose of PDL was injected the day after receiving the chemotherapy regimen in each cycle. The second arm received a subcutaneous injection of PDG for six consecutive days in each cycle of treatment. The side effects of GCF treatment and its effect on blood parameters were compared in each cycle and during eight cycles of chemotherapy. Results Hematologic parameters showed no significant differences in any of the treatment courses between the two study groups. The comparison of WBC (p = 0.527), Hgb (p = 0.075), Platelet (p = 0.819), Neutrophil (p = 0.575), Lymphocyte (p = 705) and ANC (p = 0.675) changes during the eight courses of treatment also revealed no statistically significant difference between the two study groups. Side effects including headache, injection site reaction and muscle pain had a lower frequency in patients receiving PDL drugs. Conclusion It seems that PDL is non-inferior in efficacy and also less toxic than PDG. Since PDL can be administered in a single dose and is also less costly, it can be regarded as a cost-effective drug for the treatment of chemotherapy-induced neutropenia. Trial registration IRCT20190504043465N1, May 2019.

scholarly journals Biomechanical Aspects of the Foot Arch, Body Balance and Body Weight Composition of Boys Training Football

2021 ◽  
Vol 18 (9) ◽  
pp. 5017
Author(s):  
Joanna M. Bukowska ◽  
Małgorzata Jekiełek ◽  
Dariusz Kruczkowski ◽  
Tadeusz Ambroży ◽  
Jarosław Jaszczur-Nowicki
Keyword(s):  
Body Composition ◽  
Body Height ◽  
Study Groups ◽  
The Body ◽  
Whole Body ◽  
Training Methods ◽  
Training Experience ◽  
Mean Values ◽  
Significance Level ◽  
Body Balance

Background: The aim of the study is to assess the body balance and podological parameters and body composition of young footballers in the context of the control of football training. Methods: The study examined the distribution of the pressure of the part of the foot on the ground, the arch of the foot, and the analysis of the body composition of the boys. The pressure center for both feet and the whole body was also examined. The study involved 90 youth footballers from Olsztyn and Barczewo in three age groups: 8–10 years, 11–13 years old, and 14–16 years. The study used the Inbody 270 body composition analyzer and the EPSR1, a mat that measures the pressure distribution of the feet on the ground. Results: The results showed statistically significant differences in almost every case for each area of the foot between the groups of the examined boys. The most significant differences were observed for the metatarsal area and the left heel. In the case of stabilization of the whole body, statistically significant differences were noted between all study groups. In the case of the body composition parameters, in the examined boys, a coherent direction of changes was noticed for most of them. The relationships and correlations between the examined parameters were also investigated. The significance level in the study was set at p < 0.05. Conclusions: Under the training rigor, a statistically significant increase in stability was observed with age. The total length of the longitudinal arch of both feet of the examined boys showed a tendency to flatten in direct proportion to the age of the examined boys. Mean values of the body composition parameters reflect changes with the ontogenetic development, basic somatic parameters (body height and weight) and training experience, and thus with the intensity and volume of training. This indicates a correct training process that does not interfere with the proper development of the body in terms of tissue and biochemical composition.

Surface Roughness of Two CAD/CAM Restorative Materials as Affected by Chewing Simulation v1

2022 ◽  
Author(s):  
eaeldwakhly not provided
Keyword(s):  
Surface Roughness ◽  
Computer Aided Design ◽  
Surface Characteristics ◽  
Ceramic Materials ◽  
Study Groups ◽  
Significance Level ◽  
Chewing Simulation ◽  
Computer Aided ◽  
Cad Cam ◽  
The Individual

This study was conducted to assess the surface characteristics in terms of roughness of two CAD/CAM (Computer-Aided-Design/Computer-Aided Manufacturing)restorative material spre and post chewing simulation exposure. Methods: Specimens were prepared from two CAD/CAM ceramic materials: Cerec Blocs C and IPS e-max ZirCAD. A total of 10 disks were prepared for each study group. 3D optical noncontact surface profiler was used to test the surface roughness (ContourGT, Bruker, Campbell, CA, USA). A silicone mold was used to fix the individual samples using a self-curing resin. Surface roughness (SR) was examined pre and post exposure to chewing simulation. 480,000 simulated chewing cycles were conducted to mimic roughly two years of intraoral clinical service. The results data was first tested for normality and equal variance (Levene’s test >0.05) then examined with paired and independent sample t-test at a significance level of (p < 0.05). Results:The two CAD-CAM materials tested exhibited increased surface roughness from baseline. The highest mean surface roughness was observed in Cerec blocs C group after chewing simulation (2.34 µm± 0.62 µm). Whereas the lowest surface roughness was observed in IPS e.max ZirCAD group before chewing simulation (0.42 µm± 0.16 µm). Both study groups exhibited significantly different surface roughness values (p< 0.05). There was a statistically higher surface roughness values after the chewing simulation in Cerec blocs C when compared to IPS e.max ZirCAD groups (p = 0.000).Conclusion:Even though both tested CAD/CAM materials differ in recorded surface roughness values, results were within clinically accepted values.

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