scholarly journals Role of mifepristone in induction of labour in pregnant women with previous lower section caesarean section with IUFD in late preterm and term pregnancies

2017 ◽  
Vol 6 (2) ◽  
pp. 707
Author(s):  
Ram Kanwar Deora ◽  
Nikhila G. Shetty
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Induction Of Labour ◽  
Late Preterm ◽  
Cervical Ripening ◽  
Fetal Demise ◽  
Short Term Study ◽  
Score Analysis ◽  
Near Term

Background: The objective of the study was to evaluate efficacy and safety of oral mifepristone for preinduction cervical ripening and induction of labour in late preterm and term pregnancies with previous caesarean section with intrauterine fetal demiseMethods: This prospective short term study was conducted at Umaid hospital SNMC Jodhpur Rajasthan January 2016 to November 2016. 100 subjects with previous uses beyond 34 week with intrauterine fetal demise and bishop’s score<6 were included. Tablet mifepristone 200mg was given orally after taking written in informed consent. The same dose was repeated after 24 hour according to bishop’s score. Analysis was done with respect to maternal outcome of vaginal delivery, CS, duration of labour.Results: Among 100 subjects, 97 delivered vaginally (97%) delivered within 72 hour of 1% dose. Improvement of bishop’s score was observed in 1 subject (1%), which later required augmentation by oxytocin followed by vaginal delivery.1 subject (2%) failed to respond and required caesarean section, 72 hour after given of 1st dose.Conclusions: Mifepristone can be used safely and effectively for induction of labour in previous one and two LSCS near term and term pregnancies to avoid CS rates.

scholarly journals Induction of Labour in Prelabour Rupture of Membranes with or without Cervical Ripening with Prostaglandin E2

2014 ◽  
Vol 2 (1) ◽  
pp. 4
Author(s):  
Shreyashi Aryal ◽  
Chanda Karki
Keyword(s):  
Caesarean Section ◽  
Prostaglandin E2 ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Cervical Priming ◽  
Group 5 ◽  
A Prospective Study

Objective: To compare the outcome of induction of labour with titrated dose of oxytocin with or without pre induction cervical ripening using prostaglandin E2. Methods: This is a prospective study. Sixty women with prelabour rupture of membranes (PROM) and Bishops score of less than six were randomly assigned to either immediate induction with intravenous oxytocin drip or induction with intravenous oxytocin drip preceded by cervical priming with prostaglandin E2 (PGE2) gel 0.5mg instilled intracervically. These two groups were compared regarding the mode of delivery, induction to delivery interval and maternal and neonatal morbidities. Results: Cervical priming with PGE2 resulted in lesser number of caesarean section (5 Vs. 12) and lower incidence of meconium stained liquor (n=6 Vs. n=2). Induction to vaginal delivery interval was shorter when cervical priming was done (5.4 hrs Vs 7.9 hrs). The maternal morbidity was negligible (<1%) in both the groups. The number of neonates with birth asphyxia (n=2) and the need for their resuscitation (n=2) was more in the oxytocin group but the need of antibiotics for the neonates was more in PGE2 group (5% Vs. 3%). Conclusion: Induction of labor with oxytocin, with or without cervical priming with vaginal PGE2 gel, are both reasonable options in cases of PROM, since they result in statistically non significant rates of maternal and neonatal morbidities and caesarean section. Cervical priming with prostaglandin results in higher rate of vaginal delivery and shorter induction to vaginal delivery interval and this is viewed as an advantage to the mother.

scholarly journals A comparative study of intra-cervical foley’s catheter and PGE2 gel for induction of labour at term

2019 ◽  
Vol 8 (9) ◽  
pp. 3689
Author(s):  
Anjali R. Kanada ◽  
Mahima Jain
Keyword(s):  
Side Effects ◽  
Caesarean Section ◽  
Comparative Study ◽  
Foley Catheter ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Mechanical Methods ◽  
Significant Difference ◽  
Foley’S Catheter

Background: In cervical ripening, before induction of labour, is needed to increase the success of labour induction, to reduce complications and to diminish the rate of caesarean section and duration of labour. Pharmacological preparations are in widespread use for cervical ripening but are not free from side-effects and complications. Mechanical methods, i.e. the use of Foley’s catheter balloon, though effective have not gained much popularity because of the fear of infection. Therefore, the study has been conducted to prove the efficacy and safety of extra amniotic Foley catheter balloon and to compare it with intra-cervical prostaglandin E2 (PGE2) gel. The objective of the study was to the success of induction of labor depends on the cervical status at the time of induction. For effective cervical ripening both Foley's catheter and PGE2 gel are used. The aim of this study was to compare the efficacy of intra cervical Foley's catheter and intra cervical PGE2 gel in cervical ripening for the successful induction of labor.Methods: A randomized, comparative study was conducted in the department of obstetrics and gynaecology, Civil hospital, B.J. Medical College Ahmedabad, during a period of 8 month from September 2018 to April 2019. 100 patients at term with a Bishop's score ≤5 with various indications for induction were randomly allocated to group F (intra-cervical Foley’s catheter) and group P (PGE2 gel) with 50 women included in each group.Results: The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed significant change in the Bishop's score, 5.10±1.55 and 5.14±1.60 for Foley's catheter and PGE2 gel, respectively, p <0.001. However there was no significant difference between the two groups. There was no significant difference in the side effects and caesarean section rate in both groups. The induction to delivery interval was 16.01±5.50 hours in group F and 16.85 ± 3.81 hours in group P (p=0.073). Apgar scores, birth weights and NICU admissions showed no significant difference between the two groups.Conclusions: The study shows that both Foley's catheter and PGE2 gel are equally effective in pre induction cervical ripening.

scholarly journals Use of Misoprostol in Pregnancy- A Review Article

2012 ◽  
Vol 22 (2) ◽  
pp. 94-98
Author(s):  
Syeda Ummay Kulsum ◽  
Sabera Khatun ◽  
SM Shahnawaz Bin Tabib
Keyword(s):  
Prostaglandin E2 ◽  
Review Article ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Pharmacological Agents ◽  
Tablet Form ◽  
Cytoprotective Agent ◽  
Medicine Today

Prostaglandins are the pharmacological agents used for induction of labour and augmentation of labour. Prostaglandin E2 gel is used for cervical ripening and induction of labour. These are however, costly and need to be stored in a refrigerator at a temperature of 2 - 8°C, half life 18 months. The Tablet form of prostaglandin E2 is not available in Bangladesh. Misoprostol, a synthetic prostaglandin (PG) E1 analogue is used orally for the treatment of gastric and duodenal ulcer and used as a cytoprotective agent. It was first used for labour induction in 1987. Prostaglandin can be used in several gynaecological and obstetric conditions. It can be given through several routes. This article will elaborately delinate the role of misoprostol, a prostaglandin in obstetrics and gynaecological conditions. Medicine Today 2010 Volume 22 Number 02 Page 94-98 DOI: http://dx.doi.org/10.3329/medtoday.v22i2.12443

scholarly journals Mifepristone as pre-induction cervical ripening agent: a review article

2019 ◽  
Vol 8 (11) ◽  
pp. 4636
Author(s):  
Nikita . ◽  
Seetesh Ghose ◽  
Setu Rathod
Keyword(s):  
Adverse Effects ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Review Article ◽  
Induction Of Labour ◽  
Present Review ◽  
Cervical Ripening ◽  
Successful Induction

Induction of labour after the period of viability by any methods medical, surgical or combined, for the purpose of vaginal delivery. The success of induction, to a great extent, depend upon pre-induction cervical status i.e. cervical ripening. So, ripening of cervix prior to induction i.e. pre-induction cervical ripening is one of the important steps for successful induction of labour. There are different methods for cervical ripening like prostaglandins (PGE). However, use of prostaglandins (PGE) and oxytocin as labour inducing agent has its own adverse effects on maternal and perinatal outcome. So, constant efforts are made for the less use of uterotonins. The present review aims to study the efficacy of oral Mifepristone for improvement in Bishop’s score, requirement of additional uterotonics, induction delivery interval, mode of delivery and neonatal outcome. Electronic databases were searched by using keywords ‘Mifepristone, RU486, PGE2 gel, Cervical ripening, Bishop’s score and Induction of labour’ and eleven articles were found from 2009 to 2018 which fulfils our study criteria and thus they were taken for review. Based on all the studies, Mifepristone appears to be effective cervical ripening in comparison to other agents with significant improvement in Bishop’s score, higher vaginal delivery rate, shorter induction delivery interval and good neonatal outcome.

The Role of Stillbirth Prevention and Late Preterm (Near-Term) Births

2006 ◽  
Vol 30 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Gary D.V. Hankins ◽  
Monica Longo
Keyword(s):  
Late Preterm ◽  
Near Term ◽  
Term Births

scholarly journals A review of maternal and fetal outcome of induction of labour with Foley’s catheter and extra amniotic saline infusion in women with previous caesarean delivery

2018 ◽  
Vol 7 (9) ◽  
pp. 3551
Author(s):  
Sunil Kumar ◽  
Nishtha A. Mahabalshetti ◽  
Dinu Simon Dinu Simon
Keyword(s):  
Caesarean Section ◽  
Low Cost ◽  
Foley Catheter ◽  
Fetal Outcome ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
P Value ◽  
Time Interval ◽  
Singleton Pregnancy ◽  
Foley’S Catheter

Background: Incidence of induction of labour has increased in the recent past due to increased screening facilities like ante partum fetal surveillance. Vaginal birth after caesarean section (VBAC) is one of the strategies developed to control the rising rate of caesarean sections. Intracervical Foley’s catheter reduces the risk of uterus hyper tonicity and rupture in women with one caesarean section as it’s placement induces the cervical repining without inducing any uterine contractions.Methods: A prospective study of 35 women with one previous LCSs, term gestation and singleton pregnancy, were selected for trial of labour (TOL) considering inclusion and exclusion criteria.Results: Out of 35 cases studied 21 cases (60%) went for successful induction with Foleys and the remaining 40% underwent caesarean section. The mean time interval for Foley’s expulsion was 6.74 in the success group and 10.04 in the failed group (p value <0.05). In 4 cases there were meconium stained liquor, and they underwent emergency LSCS. One case (2.8%) had scar rupture which also underwent caesarean section.Conclusions: This study shows that the Foley catheter is an effective method of cervical ripening with additional benefit of low cost, reversibility, easy availability and lack of need for special storage. This method confers significant improvement in Bishop Score and vaginal delivery was achieved in majority of patients.

scholarly journals Minimal adverse outcomes of postnatal cytomegalovirus infection in term or late preterm infants

2019 ◽  
Author(s):  
Jie Chen ◽  
Yineng Zhou ◽  
Liping Chen ◽  
Chenyu Xu ◽  
Lanhua Liu ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Clinical Outcomes ◽  
Vaginal Delivery ◽  
Preterm Infants ◽  
Infection Rate ◽  
Adverse Outcomes ◽  
Late Preterm ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cmv Infection ◽  
Late Preterm Infants

Abstract Background: To investigate at what extent breastfeeding and vaginal delivery can increase mother-to-child transmission of cytomegalovirus (CMV) and to observe the clinical outcomes of postnatal CMV infection in infants. Methods: In this secondary study of prospectively collected clinical data and serum samples, April 2012 through March 2015, 380 pregnant women with CMV IgG positive/CMV IgM negative and their 384 infants (4 twin pairs) with gestational age ≥32 weeks were included. CMV IgG and IgM were measured with enzyme-linked immunosorbent assay. Results: Of 384 infants followed up at 10.2 ± 2.3 months age, 177 (46.1%) were defined with CMV infection based on the presence of higher CMV IgG levels than in their mothers. The infection rate in 190 breastfed infants was higher than in 194 formula-fed infants (62.6% vs 29.9%, P < 0.001). Vaginally delivered infants (172) had higher CMV infection rate than 212 infants delivered by caesarean section (55.2% vs. 38.7%, P = 0.001). Compared with formula feeding and caesarean section, breastfeeding and vaginal delivery increased postnatal CMV infection respectively (OR = 3.801, 95% CI 2.474‒5.840, P < 0.001; OR = 1.818, 95% CI 1.182‒2.796, P = 0.007). Nevertheless, CMV-infected infants normally developed and did not show adverse clinical outcomes compared to uninfected infants. Conclusions: Breastfeeding and vaginal delivery can increase postnatal CMV infection; however, the infection does not cause adverse events in term or late preterm infants. Detection of CMV DNA in breastmilk should not be routinely performed, and breastfeeding should be encouraged in these infants.

Induction of Labour with Prostaglandin E2 Tablets

1975 ◽  
Vol 3 (2) ◽  
pp. 73-76 ◽  
Author(s):  
H K Basu ◽  
K T J Rajan
Keyword(s):  
Adverse Effects ◽  
Prostaglandin E2 ◽  
Vaginal Delivery ◽  
Induction Of Labour ◽  
Prostaglandin E ◽  
Multiparous Women ◽  
Near Term

Prostaglandin E2 tablets were administered orally following amniotomy to 46 primagravid and 54 multiparous women at or near term. Of these, 96 women had vaginal delivery with an average induction-delivery interval of 8 1/2 hours. Vomiting and or diarrhoea occurred in 9 women. No adverse effects on the foetus were apparent. The safety, ease and convenience of administration were obvious to the patients and staff.

scholarly journals A comparative study of misoprostol oral versus vaginal route for induction of labour

2020 ◽  
Vol 9 (5) ◽  
pp. 1907
Author(s):  
Apratim Mohan DebBarma ◽  
Jahar Lal Baidya ◽  
Debasis Ray
Keyword(s):  
Clinical Trial ◽  
Vaginal Delivery ◽  
Caesarean Section Rate ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Placebo Control ◽  
Vaginal Route ◽  
Double Blind ◽  
Outcome Differences

Background: Induction of labour at term is a common obstetric intervention. Prostaglandin E2 has been the agent of choice for pre-induction of cervical ripening for several decades. In recent time, prostaglandin E1 analogue (misoprostol) is a preferred new agent for pre-induction cervical ripening and labour induction owing to inexpensive, stable in room temperature, administrable through several routes. The ideal dose, route, and frequency of administration of misoprostol are still under investigation.Methods: A double blind parallel group placebo control randomized clinical trial was done in the department of obstetrics and gynecology of Agartala Govt. Medical College among 130 pregnant women those required induction of labour. In this clinical trial, the women were allocated by lottery to receive oral misoprostol (25 μg) and vaginal placebo (same dosage) or vaginal misoprostol (25 μg) and oral placebo (same dosage. Both active and placebo drug (25 mcg) were repeated at 4 hours. interval till the parturient reached active labour (not exceeding 5 doses). Both primary (induction delivery interval) and secondary outcomes (failed induction, vaginal/caesarean delivery rate, maternal and foetal complications) were statistically analyzed.Results: The mean induction delivery interval (primary outcome) differences were insignificant among both groups (oral versus vaginal). Success rate of induction (56.9% versus 75.4%), mean dosage (misoprostol 90.5 mcg versus 96 mcg) requirement, maternal and foetal complications was indifferent among two groups. The rate of vaginal delivery (within 24 hours of induction) was significantly higher when misoprostol was used through vaginal route. Caesarean section rate trends to be higher when misoprostol was administered orally.Conclusions: Low dose of misoprostol (25 mcg) offer an additional statistically significant clinical advantage in successful vaginal delivery when used vaginally.

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