scholarly journals A study comparing vaginal misoprostol alone with vaginal misoprostol in combination with Foley catheter for cervical ripening and labour induction

2017 ◽  
Vol 6 (2) ◽  
pp. 485 ◽  
Author(s):  
Binti R. Bhatiyani ◽  
Manisha R. Gandhewar ◽  
Swati Kapsikar ◽  
Pradip Gaikwad
Keyword(s):  
Foley Catheter ◽  
Active Phase ◽  
Fetal Distress ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Combination Group ◽  
Maternal Complications ◽  
Misoprostol Group ◽  
Vaginal Misoprostol

Background: Induction of labor is a commonly practised intervention in modern obstetrics. The objective of this study was to compare the efficacy of vaginal misoprostol alone with vaginal misoprostol in combination with Foley catheter for labour induction. It aims to assess the induction delivery interval, the outcome of labour, the incidence of instrumental delivery and Cesarean section. The neonatal outcomes and maternal complications would also be assessed.Methods: 105 women with singleton viable pregnancies of 28 weeks or more gestation with cephalic presentation, intact membranes and an unfavorable cervix (Bishops score less than 6) were randomly assigned to induction of labor using vaginal misoprostol or Foley catheter in combination with vaginal misoprostol. Women in the misoprostol only group received 25 micrograms of misoprostol per vagina every 4 hours for a maximum of six doses. Whereas women in the combination group received vaginal misoprostol and in addition Foley catheter was introduced through the cervix for 12 hours. Interruption of the trial was done in case of failure to enter the active phase of labour after 24 hours of induction, fetal distress, hyperstimulation, hypersensitivity to drugs.Results: The induction to delivery time was shorter in misoprostol group as compared to the Foley with misoprostol group by 3 hours. There was no significant change in Bishops score after induction with Foley in combination with misoprostol as compared to misoprostol alone. There was no increase in the maternal and fetal complications in the misoprostol group as compared to Foley with misoprostol.Conclusions: Misoprostol alone was more efficacious for ripening and inducing agent as compared to Foley in combination with misoprostol.

scholarly journals Comparative study of misoprostol sublingually and dinoprostone gel intracervically for cervical ripening and induction of labor

2017 ◽  
Vol 6 (8) ◽  
pp. 3624
Author(s):  
Shikha Yadav ◽  
Nootan Chandwaskar
Keyword(s):  
Mode Of Delivery ◽  
Cost Effective ◽  
Active Phase ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Cost Effective Method ◽  
Sublingual Misoprostol ◽  
Misoprostol Group ◽  
Oxytocin Augmentation ◽  
Live Fetus

Background: Both Prostaglandin E1 and E2 analog are being used for cervical ripening. The aims of study was to compare the efficacy and safety profile of sublingual misoprostol (PGE2) and intracervical dinoprostone (PGE1) for cervical ripening and induction of labor.Methods: One hundred women with single live fetus and with gestational age of more than 37 weeks admitted for induction of labor were recruited for the study. Patients were randomized to receive either 25μg of misoprostol sublingually or dinaprostone gel (0.5mg) intracervically.Results: There was shorter induction to active phase, induction to delivery time intervals and less requirement of oxytocin augmentation in misoprostol group than dinoprostone gel group. Incidence of tachysystole was higher in misoprostol group than dinoprostone gel group (22% vs 10%) however this was not statistically significant. Mode of delivery, maternal and neonatal complications were similar in both the groups.Conclusions: Use of misoprostol in lower dose is a safe and cost-effective method for cervical ripening and induction of labor.

scholarly journals Comparative study of intra vaginal misoprostol (PGE1) with intracervical dinoprostone (PGE2) gel for induction of labour

2018 ◽  
Vol 7 (9) ◽  
pp. 3769
Author(s):  
Bina M. Raval ◽  
Nainesh S. Zalavadiya ◽  
Pushpa A. Yadava ◽  
Shital T. Mehta
Keyword(s):  
Caesarean Section Rate ◽  
Cost Effective ◽  
Active Phase ◽  
Cross Sectional Study ◽  
Cervical Ripening ◽  
Cross Sectional ◽  
Misoprostol Group ◽  
The Mean ◽  
Vaginal Misoprostol ◽  
Mean Time

Background: Labour is a final consequence of Pregnancy and is inevitable. The timing of labour may vary widely but it will happen sooner or later. The aim of the present research was to study the safety, efficacy and effect of intra vaginal Misoprostol and intra cervical Dinoprostone gel for induction of labour.Methods: 100 patients who required labour of induction were included in this prospective cross-sectional study from September 2017- March 2018. 50 patients of them received 25mcg tablet misoprostol intravaginal and 50 patients of them required 0.5mg intracervical dinoprostone gel and doses were repeated every 6 hourly for up to maximum 6 doses for Misoprostol and 3 doses for Dinoprostone gel.Results: The majority of patients had gestational age above 40 weeks and between 37-40 weeks in PGE2 and PGE1 group respectively. The mean time taken for the onset of labour was less in Misoprostol than in Dinoprostone group (43.22min v/s 1 hr40 min). The mean time taken for induction to active phase of labour (1hr 42min v/s 4hr 10min) and active phase to delivery (3hr 6min v/s 4hr54min) was less in Misoprostol than Dinoprostone group. The mean time required for induction to delivery was less in Misoprostol group (5hr 2min v/s 11hrs). Requirement of oxytocin for augmentation of labour was almost equal in both groups. Caesarean section rate was less in Misoprostol group (10% v/s 22%). Maternal side effects were minimal in either groups and neonatal outcome was good in both the groups.Conclusions: Both Misoprostol and Dinoprostone gel are safe, effective for cervical ripening and induction but Misoprostol is more cost effective and stable at room temperature.

scholarly journals Efficacy of misoprostol over dinoprostone gel as a cervical ripening agent: a comparative study

2017 ◽  
Vol 6 (12) ◽  
pp. 5251 ◽  
Author(s):  
Pankajkumar B. Nimbalkar ◽  
Jaldhara N. Patel ◽  
Nilesh Thakor
Keyword(s):  
Age Groups ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Healthy Baby ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Maternal Mortality And Morbidity ◽  
Misoprostol Group ◽  
Vaginal Misoprostol ◽  
Age Range

Background: Timely induction of labour could reduce maternal mortality and morbidity as well as assure a delivery of healthy baby. The objective of this study was to evaluate the efficacy of Misoprostol as a cervical ripening agent and its comparison with Dinoprostone gel in terms of success rate, safety, side effects and patient compliance.Methods: A total of 250 pregnant women requiring induction of labor were recruited. Out of 250 cases, 150 were induced with 50 microgram Misoprostol and 100 cases with 0.5 mg intracervical Dinoprostone gel during September 2014 to August 2017 at the department of Obstetrics and Gynaecology, GMERS Medical College, Dharpur-Patan. Written and informed consent was taken from the patients. Outcome measures, such as change in Bishop's score, need of augmentation, induction delivery interval; complications like hyperstimulation, fever and meconium passage were compared between two groups. Statistical analysis was performed by Epi Info 7.Results: Age range of the patients was 21 to 35 years. 74.8% of the patients were in 21-25 years age groups. 50.4% patients were multigravida. 57.6% patients had more than 37 weeks of pregnancy. 50.4% of the patients had premature rupture of membrane as indication of labour. The mean Bishop's score for induction was 3.21 in Misoprostol group. 81.3% patients in Misoprostol group and 93% of patients in Dinoprostone group were delivered by vaginal delivery. 60% patients delivered within 6 hours in Misoprostol group. (Misoprostol: 60%, Dinoprostone: 27%, p<0.001). Incidence of thin meconium was 11.3% in Misoprostol group, 9% in Dinoprostone group. In Misoprostol group 3.3 women had fever after induction.Conclusions: Vaginal misoprostol is more efficacious in cervical ripening and for induction of labor than Dinoprostone.

scholarly journals Postpartum Vaginal Blood Loss following Two Different Methods of Cervical Ripening

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Okon Asuquo Okon ◽  
John Egede Ekabua
Keyword(s):  
Blood Loss ◽  
Foley Catheter ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Treatment Groups ◽  
Catheter Group ◽  
Vaginal Deliveries ◽  
Misoprostol Group ◽  
The University ◽  
To Receive

Eighty women undergoing induction of labor at the University of Calabar Teaching Hospital were recruited and randomly allocated into two treatment groups (40 each), to receive either serial 50 µg doses of misoprostol or intracervical Foley catheter. Vaginal blood loss was collected and measured using an under buttocks plastic collection bag and by perineal pad weighing up to 6 hours postpartum. There were no significant differences between the two groups with respect to sociodemographic and obstetric characteristics. Comparison of blood loss in vaginal deliveries between the two groups revealed that subjects in the misoprostol group had significantly higher blood loss than subjects in the Foley catheter group (488 ± 222 versus 326 ± 106, p<0.05). In both groups, there was strong and statistically significant positive correlation between postpartum blood loss and induction delivery interval (r=0.75, p<0.0001; r=0.77, p<0.0001). There were no significant differences in maternal outcomes. In view of this, further study is required to ascertain if lower doses of misoprostol for induction of labor may result in lesser blood loss. This trial is registered with ISRCTN14479515.

scholarly journals Comparison of low dose vaginal misoprostol with Foley catheter balloon as preinduction cervical ripening agents in term pregnancies

2020 ◽  
Vol 1 ◽  
pp. 10
Author(s):  
Dalyop Davou Nyango ◽  
Daloek M ◽  
Kahansim ML
Keyword(s):  
Pregnant Women ◽  
Low Dose ◽  
Foley Catheter ◽  
Comparative Trial ◽  
Tertiary Hospital ◽  
Cervical Ripening ◽  
Catheter Group ◽  
Misoprostol Group ◽  
Uterine Hyperstimulation ◽  
Vaginal Misoprostol

Objective: One of the obstetricians’ nightmare is managing high-risk pregnancies. Also, the emerging trend by pregnant women requesting for specific delivery dates for social reasons adds to this burden. In both instances, the obstetrician is faced with the challenge of inducing labor where the cervix is still unfavorable. The objective of the study was to compare the effectiveness of loe dose vaginal misoprostol and transcervical extra-amniotic Foley catheter balloon as pre-induction cervical ripening agents in term pregnancies. Material and Methods: This was a prospective, single-blind, randomized comparative trial at a tertiary hospital. Pregnant women at term in whom induction of labor was indicated, who made the inclusion criteria and who gave their consent were randomly assigned to either the vaginal misoprostol or the Foley catheter balloon group. Oxytocin was used for the augmentation of labor subsequent to the artificial rupture of the membranes according to the departmental protocols. Results: One hundred and fifty women were recruited and randomized (75 in each group). In the misoprostol group, 58 (77.3%) women achieved cervical ripening (cervical dilation of ≥4) within 12 h, compared to 43 (57.3%) in the Foley catheter balloon group. Spontaneous vaginal delivery within 12 h was 88.0% and 66.3% in the misoprostol and Foley catheter group, respectively. However, 34.7% in misoprostol group had precipitate labor (induction-to-delivery interval ≤3 h), while 9.3% in the Foley catheter group had prolonged labor. There were no significant differences in the incidence of meconium staining and 1st min Apgar scores of the babies in the two groups. Conclusion: Low dose (25 μg) vaginal misoprostol is a more effective pre-induction cervical ripening agent compared to the conventional transcervical extra-amniotic Foley catheter balloon method. While uterine hyperstimulation is the major risk in the misoprostol group, long induction-to-delivery interval is associated with labors induced following use of Foley catheter balloon as the pre-induction cervical ripening agent.

Intravenous Dexamethasone Versus Vaginal Misoprostol in Enhancing Cervical Ripening and Labor Induction

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Mahmoud Salman ◽  
Fekria Ahmed Salama ◽  
Mina Yacoub
Keyword(s):  
Total Duration ◽  
Active Phase ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Control Group ◽  
P Value ◽  
Time Interval ◽  
Vaginal Misoprostol ◽  
Mean Time

Abstract Background Induction of labor is one of the most common procedures performed in the world of Obstetrics. Traditionally, labor induction is performed using prostaglandin and oxytocin. However, usage of corticosteroids nowadays is gaining a lot of interest regarding its effects on cervical ripening and shortening the physiological process of labor. Aim of work to evaluate the efficacy of intravenous dexamethasone versus vaginal misoprostol in enhancing cervical ripening and labor induction. Patients and Methods A randomized controlled clinical trial was carried out at Ain Shams University Maternity Hospital on (60) full term pregnant women between 39 – 42 weeks undergoing induction of labor, during a period from April 01, 2019 to November 30, 2019. Pregnant women were divided into two groups; vaginal misoprostol (control) group and intravenous dexamethasone (experimental) group (30 cases each). Results Our study showed that the mean time interval (hours) from initiation of labor induction to initiation of active phase was statistically significantly shorter among the dexamethasone (experimental) group 7.36 ± 2.23 versus 12.20 ± 4.92 hours among the vaginal misoprostol (control) group (p value &lt; 0.001). Also, the mean time interval of the total duration between the induction of labor to successful vaginal delivery was statistically significantly shorter among the dexamethasone group 10.90 ± 4.17 versus 19.20 ± 5.62 hours among the vaginal misoprostol group (p value &lt; 0.001). The results of this study showed the rate of initiation of active phase and rate of successful vaginal delivery were more in the experimental dexamethasone group than the control vaginal misoprostol control group. Conclusion Intravenous injection of 8 mg of dexamethasone before induction of labor is found to shorten the duration of labor induction by reducing the time interval between the initiation of labor induction and onset of active phase and the total duration from initiation of labor induction to delivery with no marked maternal or fetal complications. Recommendations Intravenous Dexamethasone can help cervical ripening and accelerate induction of labor. Further research should be taken in consideration with more population for more global evaluation.

scholarly journals Efficacy of 50µg oral misoprostol versus 25µg vaginal misoprostol in induction of labor

2017 ◽  
Vol 6 (5) ◽  
pp. 1782
Author(s):  
Beenakumari R. ◽  
Radhamani Mavunkal Viswanathan ◽  
Nithya R.
Keyword(s):  
Mode Of Delivery ◽  
Induction Of Labor ◽  
Maternal Complications ◽  
Medical College ◽  
Oral Misoprostol ◽  
Misoprostol Group ◽  
Oral Group ◽  
Uterine Hyperstimulation ◽  
The Mean ◽  
Vaginal Misoprostol

Background: Misoprostol is the latest drug for induction of labour which is cheap and stable at room temperature. Our study was conducted to test the efficacy of misoprostol for labor induction through oral and vaginal route.Methods: 250 women who required induction of labor at Govt. Medical College, Kottayam was included in this study. Both oral misoprostol 50µg and vaginal misoprostol 25µg 4 hourly upto maximum of four doses were used for induction of labor as per consultant’s preference. Out of these 125 patients were selected for study in both groups. Singleton term pregnancies with cephalic presentation were selected. The mean induction pain interval, induction delivery interval, mode of delivery, maternal complications like uterine contraction abnormalities, neonatal complications were observed.Results: Induction to pain interval was shorter in oral misoprostol group compared to vaginal misoprostol group (2.48+1.3 hours vs. 3.91+2.17 hours P ≤0.001). But the mean induction to delivery interval was comparable in both groups (12.98±3.04hrs vs. 12.59±3.28 hrs.) Vaginal delivery and cesarean section rate in both groups were comparable. The oral group required more number of misoprostol (>2 misoprostol 38.4% in oral 25.6% in vaginal p=0.030). There was insignificant increased incidence of uterine hyperstimulation in vaginal group. The neonatal outcome was comparable.Conclusions: Misoprostol administered either by oral or vaginal route was equally effective in induction of labor and found to be safe.

scholarly journals INDUCTION OF LABOR

2011 ◽  
Vol 18 (02) ◽  
pp. 201-207
Author(s):  
TAHIRA JABBAR ◽  
SHAMAILA FAISAL ◽  
FAIQA IMRAN ◽  
Robina Kauser
Keyword(s):  
Prostaglandin E2 ◽  
Foley Catheter ◽  
Balloon Catheter ◽  
Fetal Distress ◽  
Induction Of Labor ◽  
The Other ◽  
Cervical Ripening ◽  
Prostaglandin E ◽  
Additional Advantage ◽  
Significant Difference

background: Labor can be induced through a myriad of ways. The aim of this study was to compare the effectiveness of the intracervical Foley balloon catheter and intra vaginal 3 mg prostaglandin E2 tablet(s) in preinduction cervical ripening at term. Methods: Prospective analytic study of a cohort of 280 women selected through non probability sampling admitted in Obstetrics units, in two private hospitals one at Rawalpindi and the other at Mirpur (Azad Kashmir), from January 2009 to March 2010. All women were randomized to receive an intracervical Foley catheter or prostaglandin E2 tablets. The primary measured outcome was ripening of the cervix as measured with the Bishop score. Results: There were no differences in mean Bishop Scores between the prostaglandin and the Foley catheter groups. Bishop scores (mean ± S.D.) after ripening were 6.6±0.81 and 6.7±0.86 for the Foley catheter and prostaglandin groups, respectively (P=0.54). The prostaglandin group showed a statistically shorter induction to delivery time compared with the Foley catheter (16.5±2.2 and 20.51±3.89 h, respectively (P<0.01). Both the groups showed no statistically significant difference between the occurrences of spontaneous vaginal delivery. Labor was established in 72% cases of cervical Foley group. On the other hand induction occurred in 76% cases in prostaglandin group. There was no statistical difference between the need of oxytocin infusion for labor augmentation between the two groups and fetal distress was equally frequent in both the groups. Conclusions: Foley catheter was as effective as Prostaglandin E-2 at term for induction of labor with additional advantage of being cheaper, readily available and had no systemic side effects. 

scholarly journals Profiling cervical ripening for induction of labour with Foley’s balloon catheter in Ebonyi state, Nigeria: a randomized controlled trial

2021 ◽  
Vol 10 (1) ◽  
pp. 22
Author(s):  
Nnabugwu Alfred Adiele ◽  
Christian C. Mgbafulu ◽  
Arinze Chidiebere Ikeotuonye ◽  
Christian Chidebe Anikwe ◽  
Joshua Adeniyi Adebayo ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Foley Catheter ◽  
Balloon Catheter ◽  
Active Phase ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Controlled Study ◽  
Bishop Score ◽  
Randomized Controlled

Background: The ripeness of the cervix is an important prerequisite to a successful labour induction. Use of extra-amniotic Foley catheter is a mechanical method of cervical ripening with proven efficacy. This study compared the difference in efficacy between 30 ml and 60 ml of water for inflation of Foley catheter balloon when used for cervical ripening during induction of labour.Methods: A single-blind randomized controlled study where 260 term pregnant women with intact membranes and unfavourable cervix were selected for induction of labour and randomized into two equal groups (30 ml- and 60 ml- groups) from October, 2019 to July 2020. Each participant had cervical ripening with the catheter bulb inflated with either 30 ml or 60 ml of sterile water (as assigned to the individual). After achieving favourable cervix (BS ≥6), oxytocin titration was commenced and the labour monitored with the outcomes well documented and statistically analysed.Results: Mean duration to favourable Bishop Score significantly reduced in the 60 ml group (10.8 hours±2.99) as against 12.7 hours±10.0 in 30ml group (p=0.038). Mean duration of active phase of labour was significantly reduced in 60 ml group (5.6 hours±2.4) as against 8.4 hours±3.2 in 30 ml group (p=0.010). Caesarean delivery rate was significantly reduced in the 60 ml groups (p=0.027).Conclusions: The use of 60 ml inflated Foley’s balloon catheter when compared with 30mls to ripen the cervix effectively reduced the duration to favourable Bishop Score, duration of the active phase of labour and the rate of Caesarean sections.  

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