scholarly journals A study of vaginal misoprostol tablet versus intra cervical dinoprostone gel for the induction of labour

2017 ◽  
Vol 6 (4) ◽  
pp. 1404
Author(s):  
Chandni N. Badlani ◽  
Shraddha S. Shastri ◽  
Neelesh S. Risbud
Keyword(s):  
Cost Effective ◽  
Induction Of Labor ◽  
Significant Difference ◽  
Misoprostol Group ◽  
Group A ◽  
The Mean ◽  
Nicu Admission ◽  
Vaginal Misoprostol ◽  
Group B ◽  
To Receive

Background: This was a comparative study conducted to compare the effectiveness of 25 microgram of intravaginal misoprostol with intracervical dinoprostone gel in terms of efficacy of drug, feto-maternal outcome, side effects and complications of drugs.Methods: 400 nulliparas at term, admitted for induction of labor were included in this study. They were randomly selected to receive either intravaginal misoprostol or intracervical dinoprostone gel. Group A (200 women) recieved tablet misoprostol 25 micrograms vaginally 4 hrly to a maximum of 3 doses and Group B (200 women) received dinoprostone gel 0.5mg intracervically 6 hrly to a maximum of 3 doses. Comparison was done in terms of Induction to delivery interval, need for augmentation, LSCS and instrumentation rate, need for NICU admissions and cost effectiveness.Results: The mean induction to delivery interval was less in the misoprostol group than dinoprostone group (12.5 hrs vs. 20 hrs). 78% patients delivered in the first 24 hrs in misoprostol group compared to 52 % patients in dinoprostone group. Group A had a higher success rate (81% vs.76%) and also required less augmentation of labor ( 30% vs. 60%) compared to group B. Need for LSCS was also lower in misoprostol group (11% vs. 16%). Need for instrumentation and incidence of NICU admission was similar in both groups. Misoprostol was more cost effective compared to dinoprostone.Conclusions: The misoprostol group had a shorter induction to delivery interval, more number of deliveries in the first 24 hrs of induction and a reduced need of augmentation of labor with oxytocin. There was no significant difference in the rate of caesarean section, hyper-stimulation syndrome, neonatal and maternal morbidity between the two groups. Thus, misoprosol appears to be safer, cheaper and more efficacious alternative for induction of labor especially for non-fetal indications as compared to dinoprostone gel.

A STUDY OF VAGINAL MISOPROSTOL TABLET VERSUS INTRACERVICAL DINOPROSTONE FOR INDUCTION OF LABOUR

2021 ◽  
pp. 50-52
Author(s):  
P. Shabana ◽  
R. Asha Latha ◽  
N. M. Riyaz Riyaz
Keyword(s):  
Cost Effective ◽  
Induction Of Labour ◽  
Group 13 ◽  
Group 12 ◽  
Misoprostol Group ◽  
Group A ◽  
The Mean ◽  
Nicu Admission ◽  
Vaginal Misoprostol ◽  
Group B

Background:Induction of labour is the process of initiating the labour by articial means post 24 weeks of gestation. This study was undertaken to compare the efcacy and safety of vaginal Misoprostol [25-50ug] with intracervical Dinoprostone gel (0.5mg) for induction of labour at term in terms of efcacy of drug, feto-maternal outcome, side effects and complications of drugs. Methods: 400 nulliparas at term admitted in the OBG ward were included in this study. They were randomly allocated to two groups A& B. Group A (200 women) received tablet Misoprostol 25 micrograms vaginally 4 hrly to a maximum of 3 doses and Group B (200 women) received Dinoprostone gel 0.5mg intracervically 6 hrly to a maximum of 3 doses. Comparison was done in terms of induction to delivery interval, rates of instrumental and LSCS delivery, need for NICU care and cost-effectiveness. ADRs, if any were documented and proper care taken. Results: The mean induction to delivery interval was less in the Misoprostol group than Dinoprostone group (12 hrs vs. 22 hrs). 82% patients delivered in the rst 24 hrs in Misoprostol group compared to 54 % patients in Dinoprostone group. Group A had a higher success rate (80% vs.75%) and also required less augmentation of labor ( 35% vs. 65%) compared to group B. Need for LSCS was also lower in Misoprostol group (13% vs. 18%). Need for instrumentation and incidence of NICU admission was similar in both groups. Misoprostol was more cost effective compared to Dinoprostone. Conclusions: The Misoprostol group had a shorter induction to delivery interval, more number of deliveries in the rst 24 hrs of induction and a reduced need of augmentation of labor with oxytocin. There was no signicant difference in the rate of caesarean section, hyper-stimulation syndrome, neonatal and maternal morbidity between the two groups. Thus, Misoprostol appears to be safer, cheaper and more efcacious alternative for induction of labor especially for non-fetal indications as compared to Dinoprostone gel.

scholarly journals Buccal versus Vaginal Misoprostol for Term Induction of Labor: A Retrospective Cohort Study

2018 ◽  
Vol 36 (07) ◽  
pp. 765-772 ◽  
Author(s):  
Meredith L. Dorr ◽  
Rebecca C. Pierson ◽  
Joanne Daggy ◽  
Sara K. Quinney ◽  
David M. Haas
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Induction Of Labor ◽  
Premature Rupture Of Membranes ◽  
Significant Difference ◽  
Misoprostol Group ◽  
Vaginal Misoprostol ◽  
To Receive ◽  
Time To Delivery ◽  
Labor Outcomes

Objective To compare the efficacy of similar buccal and vaginal misoprostol doses for induction of labor. Study Design Retrospective chart review of 207 consecutive women undergoing term induction of labor with misoprostol. Misoprostol route and dosing were collected. Time to delivery and other labor outcomes (e.g., vaginal delivery less than 24 hours) were compared between women receiving buccal and vaginal misoprostol. Results There was no significant difference in time to delivery for women receiving buccal (median 18.2 hour, 95% confidence interval [CI] = [14.9, 21.5]) versus vaginal (median 18.3 hour, 95% CI = [15.0, 20.4]) misoprostol (p = 0.428); even after adjusting for covariates (p = 0.381). Women who presented with premature rupture of membranes were more likely to receive buccal misoprostol (92.7% received buccal vs. 7.3% received vaginal, p < 0.001). A similar number of women delivered vaginally in the buccal group (88.2%) and vaginal misoprostol group (86.8%, p = 0.835). The proportion of women who experienced uterine tachysystole or chorioamnionitis did not significantly differ by route of administration. Conclusion We found no significant differences in time to delivery or other labor outcomes between buccal or vaginal dosing of misoprostol in women undergoing labor induction at term.

scholarly journals Oral and vaginal route of misoprostol for induction of labour: a comparative study

2019 ◽  
Vol 8 (5) ◽  
pp. 1956
Author(s):  
Deepti D. Sharma ◽  
Kavita A. Chandnani
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Induction Of Labour ◽  
Vaginal Route ◽  
Oral Misoprostol ◽  
Group A ◽  
The Mean ◽  
Vaginal Misoprostol ◽  
Group B ◽  
To Receive

Background: Induction of labour can be defined as “Artificial initiation of uterine contractions before the onset of spontaneous labour, after the period of viability, by any methods, for purpose of vaginal delivery.” The key factor for a successful induction is the status of cervix, its form, consistency and dilatation which is determined by the Bishop score. In case of unfavourable cervix or in the pregnancies remote from the term; prostaglandins are more effective than any other method of induction. Introduction of misoprostol, PGE1 analogue, for the induction of labour in 1993 and its approval for clinical use by ACOG (American College of Obstetrics and Gynecology) in 1999 has been the most significant advancement. It is the latest drug for induction of labour which is cheap and stable at room temperature and is being used worldwide in different doses and by various routes. We compared the most commonly preferred two routes; vaginal and oral in terms of success of induction and noted the adverse events and side effects in both routes.Methods: This was a prospective comparative study carried out at SBKSMIRC (Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre), Dhiraj general hospital, Vadodara, Gujarat, 200 patients who required induction of labour were recruited after applying inclusion and exclusion criteria and were randomly divided in two groups- Group A meant to receive 50µg oral misoprostol, Group B - meant to receive 25µg vaginal misoprostol repeated 4 hourly up to maximum of five doses. Progress of labour was charted on the partograph. The mean induction delivery interval, mode of delivery, maternal and neonatal outcomes and complications were observed.Results: The mean induction to delivery interval was significantly less in vaginal group than oral (23.3±12.4 hours in oral vs. 17.3±10 hours in vaginal). Vaginal delivery and cesarean section rates were comparable in both groups (76% in Group A vs. 72% in Group B for vaginal delivery, 18% vs. 20% for Cesarean section, respectively). 58% patients in Group A required more than two doses as compared to 39% in group B, though the difference was statistically not significant. Significant number of patients required added oxytocin administration in Group A (72%). No major complications or adverse events were observed. Neonatal hyperbilirubinemia was seen more in Group A.Conclusions: Both Oral misoprostol in a dose of 50μg and vaginal misoprostol 25 μg every four hours, to a maximum of five doses, have the potential to induce labour safely and effectively. The vaginal route however is beneficial in effecting delivery in lesser time with few numbers of doses as compared to oral route.

TO COMPARE THE FETOMATERNAL OUTCOME OF ORAL MISOPROSTOL SOLUTION AND VAGINAL MISOPROSTOL TABLET FOR INDUCTION OF LABOUR AT TERM IN THE DEPARTMENT OF OBSTETRICS & GYNAECOLOGY, SMS MEDICAL COLLEGE, JAIPUR

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Neelam Bhardwaj ◽  
Parveen . ◽  
Prerna . ◽  
Neeta Meena ◽  
Prem .
Keyword(s):  
Controlled Trial ◽  
Meconium Aspiration Syndrome ◽  
Induction Of Labour ◽  
Medical College ◽  
Oral Misoprostol ◽  
Misoprostol Group ◽  
Group A ◽  
Nicu Admission ◽  
Vaginal Misoprostol ◽  
Group B

Background: Induction of labour is a common intervention, required in situations where continuation of pregnancy may be lifethreatening for the mother and/or fetus. In industrialized countries, the induction rate ranges from 10-25%. Methods: Randomized controlled trial was conducted at Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. Results: APGAR score at 1 min and 5 minutes was 6.64 and 6.84 in oral misoprostol and vaginal misoprostol group respectively, while at 5 minutes it is 6.7 oral group and 7 of vaginal misoprostol group. 34% of cases need NICU admission in Group-A (Oral misoprostol) and 14% in Group-B (Vaginal misoprostol) group. Meconium aspiration syndrome which is present 10% of patients in Group-A (Oral Misoprostol) while it is present in 6% of patients in Group-B (Vaginal misoprostol). Conclusion: The lesser incidence of meconium-stained liquor and NICU admissions and fewer caesareans with better neonatal outcome in women induced with oral misoprostol outweigh its advantages over the vaginal misoprostol Keywords: Misoprostol, Labor, Induction, Fetomaternal outcome.

scholarly journals Comparative Evaluation of 25µg and 50µg of travaginal Misoprostol for Induction of Labor

2013 ◽  
Vol 1 (1) ◽  
pp. 46
Author(s):  
Buddhi Kumar Shrestha ◽  
Sushila Jain ◽  
Roshi Maskey ◽  
Hasena Banu
Keyword(s):  
Induction Of Labor ◽  
Medical College ◽  
High Incidence ◽  
Oxytocin Infusion ◽  
Successful Induction ◽  
Group A ◽  
Posterior Fornix ◽  
Vaginal Misoprostol ◽  
Group B ◽  
To Receive

  Introduction: To compare the efficacy and safety of 25g vs. 50g of intravaginal (Posterior fornix) misoprostol for induction of labor in 100 patient from Jan 2012 to Dec 2012 at Lumbini Medical College.   Methods: One hundred pregnant lady requiring induction were randomly assigned to receive either 25 g (group A=50) or 50 g (group B=50) of intra vaginal misoprostol every 4 hrs till adequate contractions were achieved or maximum dose of 150 g was used.   Results: The onset of contraction was earlier in group B in 34 cases as compared to group A, where only 25 cases had earlier contraction ( P> 0.05). 38 cases (76%) in Group B and 35 cases (70%) in Group A delivered vaginally. Induction to delivery interval was shorter(<12hrs) in group B in 15 cases and in 10 cases in group A. Mean dose of Misoprostol (94micrograms) for successful induction in group B was high compared to Group A (75.5 microgram). Requirement for oxytocin infusion was higher in group A, 26% vs. 15%. Abnormal contractility pattern was seen in B group 24% cases compared to 14% cases in Group A. APGAR score < 7 at 1 min was seen in 26% neonates in Group B and in only 10% neonates in Group A. Ruptured uterus did not occur in any group.   Conclusion: 50 g dose of misoprostol is more efficacious than 25 g dose as seen in our study. However it appears to be less safe both for mother and baby due to the high incidence of tachysystole, hyperstimulation and intrauterine passage of meconium.

Combined Use of Vaginal Misoprostol with Intracervical Foley Catheter Versus Vaginal Misoprostol alone in Induction of Labor at Term Pregnancy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Hassan Swidan ◽  
Ahmed Abdel Shafy El-Shahawy ◽  
; Ahmed Mohamed Abbass ◽  
Huda Mohamed Elsayed Mohamed
Keyword(s):  
Foley Catheter ◽  
Group Versus ◽  
Maternity Hospital ◽  
Induction Of Labor ◽  
Term Pregnancy ◽  
Number Of Patients ◽  
Misoprostol Group ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Group B

Abstract Background Induction of labor should be used in the most efficient way possible that will result in a favorable obstetric outcome with minimum fetal morbidity. Objectives The aim of this study is to compare the efficacy and safety of intravaginal misoprostol alone versus intra cervical Foley catheter combined with vaginal misoprostol in induction of labor at term pregnancy. Methods This study was conducted at Obstetrics & Gynecology Department; Ain Shams University, Maternity Hospital in the period between May 2017 to October 2017. The total number of patients studied was 120 patients, divided into two groups; the first group (A) included 60 patients who received vaginal misoprostol, the second group (B) included 60 patients who received vaginal misoprostol combined with trans cervical Foley catheter. Results The current study found that the combined group has a better chance for NVD 88.3% versus 78.3% in misoprostol alone group, a lesser probability to CS 11.7% in combined group versus 21.7% in misoprostol alone group and a shorter induction delivery interval within 12 hours after induction (81.6% in combined group versus 59.5% in misoprostol group). Regarding the effect of both methods on fetal safety, we found that non reassuring FHR was more common in combined group 8.3% than misoprostol alone group 1.7% but it’s statistically non-significant. There was statistically significant increase in tachysystole in combined group 28.3% versus 13.3% in misoprostol alone group. However, dystocia was more common in misoprostol group 15% than combined group 3.3% that is also statistically significant. Conclusion Both methods can be used in induction of labor at term pregnancy without forgetting the precautions and close observation to the mother and the fetus. Combined method results in a shorter induction-to delivery time, but misoprostol alone was safer for the mother and the fetus.

CLINICAL OUTCOME AND COST COMPARISON OF CARPAL TUNNEL WOUND CLOSURE WITH MONOCRYL® AND ETHILON®: A PROSPECTIVE STUDY

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 189-192 ◽  
Author(s):  
Anis Dosani ◽  
Sameer K. Khan ◽  
Sheila Gray ◽  
Steve Joseph ◽  
Ian A. Whittaker
Keyword(s):  
Carpal Tunnel ◽  
Wound Closure ◽  
Unit Cost ◽  
Cost Effective ◽  
Cost Comparison ◽  
Absorbable Suture ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
A Prospective Study

This prospective non-randomised two-cohort study compares the use of an absorbable suture (Poliglecrapone [Monocryl]: Group A) and a non-absorbable suture (Polyamide [Ethilon]: Group B) in wound closure after elective carpal tunnel decompression. The primary outcome was scar cosmesis as assessed by the Stonybrook Scar Evaluation Scale (SBSES); the financial cost of wound closure was compared as a secondary outocome. All fifty patients completed follow-up. At six weeks, there was no significant difference in the two groups regarding scar tenderness (p = 0.5), although residual swelling was more evident in the absorbable group (p = 0.2). The mean SBSES score at six weeks was 4.72 in Group A, and 4.8 in Group B (p = 0.3). The unit cost per closed wound of Monocryl was three times than Ethilon (p < 0.05). Ethilon is thus cost-effective without compromising the cosmetic outcome, and we recommend using this as the preferred suture for closure of carpal tunnel wounds.

scholarly journals Comparison Between With Kirschner-wires Only And Combined Screw Fixation in Proximal Reverse Chevron osteotomy(PCMO) For Hallux Valgus Deformity

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Hwa Jun Kang ◽  
Hong-Geun Jung ◽  
Jong-Soo Lee ◽  
Sungwook Kim ◽  
Mao Yuan Sun
Keyword(s):  
Hallux Valgus ◽  
Screw Fixation ◽  
Fixation Method ◽  
Kirschner Wires ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Severe Hallux Valgus

Category: Bunion Introduction/Purpose: Kirschner-wires fixation, sometimes we have encountered pin irritation or pull-out. This is the reason why we consider additional fixation. Moreover, there are few reports according to comparison of fixation method, and Most of them focused on comparison K-wires or screw fixation only. Purpose of study is to compare clinical and radiographic outcome between Kirschner-wires only and combined screw fixation. Methods: The study included two different groups according to fixation methods. One with Kirschner-wires fixation (KW group) included 117 feet(of 98 patients), the other with combined screw fixation (KWS group) 56 feet (of 40 patients) with moderate to severe hallux valgus. Clinically, the preoperative and final follow-up visual analog scale (VAS) pain scores, the preoperative and final follow-up American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal (MTP)-interphalangeal (IP) scores, and patient satisfaction after the surgery were evaluated. Radiographically, the hallux valgus angle (HVA), intermetatarsal angle (IMA), medial sesamoid position (MSP), and first to fifth metatarsal width (1-5MTW) were analyzed before and after surgery. Results: The mean AOFAS score improved preoperative 65.5 to 95.3 at final follow up in group A, while preoperative 56.5 to 88.6 at final follow up. Pain VAS decreased from 5.7 to 0.5 in group A, whereas from 6.2 to 1.6 in group B. The mean HVA all improved from preoperative 38.5 to 9.3 at final follow up in group A and 34.7 to 9.1 in group B. The mean IMA and MSP also improved significantly at final follow up. In comparative analysis, the IMA did not show significant difference between postoperative and final state in group A, while showed significant increase in group B. Conclusion: We achieved favorable clinical and radiographic outcomes with minimal complications in patient with moderate to severe hallux valgus in both groups. However, this study shows no statistically significant difference in IMA during follow-up period and lower recurrence rate. Therefore we need to consider combined fixation method to provide better stability and can expect lower recurrence rate.

The role of tolvaptan in prevention of hyponatremia in patients undergoing transurethral resection of prostate surgery- A randomized double blind study

2021 ◽  
Vol 8 (2) ◽  
pp. 321-325
Author(s):  
Dinesh Kumar Singh ◽  
B B Baj ◽  
Vipin Goyal
Keyword(s):  
Transurethral Resection ◽  
Blind Study ◽  
Transurethral Resection Of Prostate ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

The aim of our study to determine the role of tolvaptan in prevention of hyponatremia in transurethral resection of prostate surgery. This is randomized double-blind study conducted in 60 ASA grade status 1 and 2 patients age group between 45-80 yrs undergoing TURP under spinal anaesthesia in urology operation theatre in Mahatma Gandhi hospital Jaipur after receiving permission from hospital ethical committee. A detailed history, complete physical examination and routine investigation were done for all patients followed by informed written consent was obtained. Patients are randomly divided into 2 groups. In group A -30 patients who received orally tab tolvaptan 15 mg and group B-30 patients who received orally tab multivitamin 2 hrs before surgery after doing electrolytes of the patients in the morning. In both groups age (in yrs), wt (in kg), ASA grade, volume of irrigating fluid (in litres), volume of prostate resected (in gm) and duration of surgery (in minutes) all demographic and surgical details data were compared. Electrolytes were compared in both groups pre and post-operatively and statistical analysis was done.There was significant difference in post-operative sodium level between the two groups (A and B). The mean level of sodium significantly reduced post-operatively in group –B (control grp). The mean level of sodium significantly increased post-operatively in group –A (tolvaptan grp). We conclude single dose of tolvaptan -15 mg found to effective in prevention of hyponatremia in patients undergoing TURP.

Clinical Results Of A Lamina With Spinous Process And An Iliac Graft As Bone Grafts In The Surgical Treatment Of Single-Segment Lumbar Pyogenic Discitis: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Weiyang Zhong ◽  
Xinjie Liang ◽  
Xiaolin Wang ◽  
Ke Tang ◽  
Tianji Huang ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Spinous Process ◽  
Bone Grafts ◽  
Clinical Results ◽  
Single Segment ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Segmental Angle

Abstract Background: A retrospective study investigated and compared the results of a lamina withspinous process (LSP) and an iliac graft (IG) as bone grafts in single-segment lumbar pyogenic discitis (LPD) through one-stage-posterior-only approach with radical debridement and internal instrumentation.Methods: Data from 37 patients were reviewed. A LSP was placed in 17 patients (group A), and an IG was implemented in 20 patients (group B). The surgery time, surgery hemorrhage, hospital stay, drainage, and follow-up (FU) were reviewed. The visual analogue scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, segmental angle, intervertebral height and bony fusion time were compared preoperatively and at the final FU.Results: All patients were followed-up for a mean of 27.94±2.35 months in group A and 30.29±1.89 months in group B, without a difference. The mean age was younger in group A than in group B (P<0.05). The surgery time, surgery hemorrhage, and hospitalization cost were lower in group A than in group B (P<0.05), except for the hospital stay and drainage time. Fever occurred in 10 patients in group A and 12 patients in group B. The ESR, CRP level, and VAS and ODI scores were significantly decreased, and there were no significant differences between the groups at the final FU. The distribution of bacterial agents in blood culture was 1 case of Aerobacter cloacae, 2 of Staphylococcus aureus, 2 of Escherichia coli, and 1 of Streptococcus viridis in group A and 1 of S. aureus，1 of Staphylococcus warneri and 2 of Klebsiella pneumoniae in group B. Pyogenic infection was observed in the pathological findings of all patients. No significant difference was found in the mean segmental angle or mean intervertebral height preoperation and at the final FU between the groups.Conclusion: The use of LSP as a new bone graft is reliable, safe, and effective for surgical management for the LPD while surgery is proposed as a good management strategy for LPD in carefully selected patients.

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