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 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 Sublingual vs Vaginal Misoprostol for Labor Induction

2012 ◽  
Vol 46 (3) ◽  
pp. 138-143
Author(s):  
Sujata Siwatch ◽  
Vanita Jain
Keyword(s):  
Uterine Contraction ◽  
Controlled Trial ◽  
Mode Of Delivery ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Randomized Controlled ◽  
Sublingual Misoprostol ◽  
Misoprostol Group ◽  
Vaginal Misoprostol ◽  
To Receive

ABSTRACT Background This study is a randomized controlled trial comparing the efficacy and safety of sublingual vs vaginal misoprostol for induction of labor. Materials and methods A total of 160 women admitted for induction of labor at the PGIMER, Chandigarh, India were randomized to receive 25 μg of vaginal or sublingual misoprostol for labor induction. The two groups were compared for mode of delivery, induction delivery interval, misoprostol dose required, uterine contraction abnormalities and neonatal outcomes. Results Majority of women in both groups delivered vaginally (91 and 89% in vaginal and sublingual misoprostol groups respectively). Mean number of doses of misoprostol required for induction of labor was similar in vaginal misoprostol group and sublingual misoprostol group (1.81 ± 0.84 vs 2.05 ± 0.98). The occurrence of uterine contraction abnormalities and neonatal outcome was similar in both groups. Conclusion The low dose of 25 μg is equally efficacious and safe by both vaginal and sublingual routes. How to cite this article Siwatch S, Kalra J, Bagga R, Jain V. Sublingual vs Vaginal Misoprostol for Labor Induction. J Postgrad Med Edu Res 2012;46(3):138-143.

scholarly journals Cervical Ripening: Comparative Study between Intracervical Balooning by Foley’s Catheter and Intravaginal Misoprostol Tablet

1970 ◽  
Vol 27 (1) ◽  
pp. 5-12
Author(s):  
Jannatul A Ferdous ◽  
Nurun Nahar Khanam ◽  
Most. Rashida Begum ◽  
Sayeba Akhter
Keyword(s):  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
College Hospital ◽  
Socioeconomic Condition ◽  
Medical College ◽  
Catheter Group ◽  
Misoprostol Group ◽  
Foley’S Catheter

This study was designed to compare the effectiveness of misoprostol and Foley's catheter on cervical ripening. A randomized clinical trial was carried out at Dhaka Medical College Hospital during the period from March 2002 to November 2002. Ninety patients, who were chosen for induction, were selected for this study, 45 patients were randomly selected for Foley's catheter group and 45 patients for misoprostol group by using lottery. The baseline characteristics like age, parity, socioeconomic condition, gestational age; Bishop's score and indication of induction of labor were almost same in both groups. Mean duration of onset of labour was 13.60±5.0 and 15.26±3.58 hours, induction-full dilatation was 18.83±2.94 and 20.03±2.46 hours and induction-delivery interval was 20.04±2.82 and 21.18±2.32 hours in the misoprostol and Foley's catheter groups respectively. The differences were not significant. Mode of delivery and fetal outcome were also same in both group. Complications like vomiting and hyperstimulation appeared in few cases in misoprostol group but not significant. From this study, it was found that the safety and efficacy of Foley's catheter is comparable to misoprostol. In addition, Foley's catheter is free from some side effects of misoprostol, like vomiting and hyperstimulation. Therefore, Foley's catheter can be used for cervical ripening. Key words: Induction of labor, Foley's catheter, misoprostol DOI: 10.3329/jbcps.v27i1.4237 J Bangladesh Coll Phys Surg 2009; 27: 5-12

scholarly journals Sublingual vs Oral Misoprostol for Labor Induction

2014 ◽  
Vol 48 (1) ◽  
pp. 33-36
Author(s):  
Sujata Siwatch ◽  
Goter Doke
Keyword(s):  
Low Dose ◽  
Uterine Contraction ◽  
Mode Of Delivery ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Routes Of Administration ◽  
Oral Misoprostol ◽  
Sublingual Misoprostol ◽  
Oxytocin Augmentation ◽  
To Receive

ABSTRACT Background This study compares the eficacy and safety of sublingual vs oral misoprostol for induction of labor. Materials and methods 160 women admitted for induction of labor at the Postgraduate Institute of Medical Education and Research, Chandigarh were randomized to receive 25 µg misoprostol orally 3 hourly or 25 µg sublingual misoprostol 4 hourly for labor induction. Outcome The two groups were compared for number of women not delivered in 24 hours, misoprostol dose required, induction delivery interval, incidence of uterine contraction abnormalities, mode of delivery, side effects and neonatal outcomes. Results Low dose of misoprostol is eficacious with both routes of administration. Majority women delivered vaginally and of them, comparable numbers in both vaginal and sublingual misoprostol groups delivered within 24 hours of induction (93.1 and 83.7%). The sublingual route is associated with a statistically signiicant lesser induction to delivery interval (14.8 ± 6.2 hours vs 17.67 ± 7.32 hours) and lesser requirement of oxytocin augmentation (62.5 vs 35%). The occurrence of uterine contraction abnormalities and neonatal outcome was similar in both groups. Conclusion The low dose of 25 µg is eficacious and safe by both sublingual and oral routes. Sublingual route has lesser induction to delivery interval and lesser requirement for oxytocin augmentation. How to cite this article Siwatch S, Doke G, Kalra J Bagga R. Sublingual vs Oral Misoprostol for Labor Induction. J Postgrad Med Edu Res 2014;48(1):33-36.

scholarly journals A study of effect of oral PGE1 and cervical PGE2 on induction of labor and mode of delivery

2018 ◽  
Vol 7 (6) ◽  
pp. 2160
Author(s):  
Sukanya Mukherjee ◽  
H. Valson ◽  
Balaji K.
Keyword(s):  
Mode Of Delivery ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
P Value ◽  
Singleton Pregnancy ◽  
Outcome Indicators ◽  
Oral Misoprostol ◽  
Vaginal Deliveries ◽  
Group A ◽  
Group B

Background: Induction of labor is one of the most important procedures done by the Obstetricians. Induction of labor with the help of prostaglandins offer the advantage of promoting cervical ripening along with stimulating the contractility of the myometrium.Methods: 200 pregnant women with singleton pregnancy both nulliparous and multiparous, were included in the study at term gestation (>39weeks) with Bishop’s score <6, and reactive NST. The subjects were divided in to two groups Group A including patients who were given oral PGE1 - 50 mcg Tab, and Group B with cervical PGE2, 0.5 mg, gel. The outcome indicators were recorded in both Group A and Group B and analyzed. The mean time taken from induction to vaginal delivery in Group A was 628±67 minutes and in Group B was 839±118 minutes. Incidence of LSCS in Group B when compared to Group A (p value <0.005).Results: Incidence of LSCS in Primi’s in Group B compared to Primi’s in Group A was statistically significant (p value 0.009). Non-progression of labor was observed to be the major indication for LSCS in Group B. Meconium stained labor was found to be the major indication for LSCS in Group A.Conclusions: The study concludes that using 50 mcg oral misoprostol, is an effective and safe mode of induction of labor in comparison to PGE2 gel. Vaginal deliveries are more with the use of oral misoprostol and the induction to delivery interval is also lesser than that in cervical PGE2 use.

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 Comparative study on cervical ripening and labour induction with dinoprostone versus foley’s catheter with extra amniotic saline infusion

2020 ◽  
Vol 9 (10) ◽  
pp. 4080
Author(s):  
Rachel Alexander A. ◽  
Gigi A.
Keyword(s):  
Gestational Age ◽  
Mode Of Delivery ◽  
Cost Effective ◽  
Similar Efficacy ◽  
Saline Infusion ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Maternal Complications ◽  
Significant Difference

Background: Induction of labour is defined as initiation of uterine contractions before spontaneous onset of labour. This observational study compares the effect of prostaglandin E2 (PGE2) and extra amniotic saline infusion (EASI) for pre-labour ripening of unfavourable uterine cervix.Methods: This was a prospective study conducted on 100 pregnant women with gestational age ≥37 weeks during a year period in the department of obstetrics and gynaecology of government TD medical college, Alappuzha, Kerala. The period of study was for one year from June 2002 to July 2003. All patients were divided into two groups. Group-1 contains 47 patients who received intracervical PGE2, (Dinoprostone gel, 0.5 mg). Group-2 contains 53 patients who were induced with EASI. The main outcome variables were the number of subjects with favourable Bishop's score, mode of delivery, maternal complications and neonatal outcomes.Results: Majority of the patients in both the groups were in the age of 21-30 years. There was significant difference in age, parity and gestational age of both groups. In this study it was found significant difference in the occurrence of hyper stimulation among PGE2 and EASI; whereas, there was no significant difference in the occurrence of maternal pyrexia among two groups. High incidence of caesarean section was found in EASI. APGAR score of new born babies was high in labour induced with PGE2.Conclusions: PGE2 and EASI have similar efficacy in induction of labour, but EASI is associated with more side effects. Cost wise EASI is more cost effective than PGE2.

scholarly journals INDUCTION OF LABOR;

2017 ◽  
Vol 24 (02) ◽  
pp. 288-292
Author(s):  
Raheela Baloch ◽  
Nigar Jabeen ◽  
Sana Zahiruddin ◽  
Ms. Kiran Mawani
Keyword(s):  
Side Effects ◽  
Prostaglandin E2 ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Efficacy And Safety ◽  
Vaginal Deliveries ◽  
Number Of Patients

Efficacy and safety of intra-vaginal prostaglandin E2 pessary for induction ofLabor. Objectives: To evaluate the efficacy and safety of intra-vaginal prostaglandin E2 pessaryfor induction of Labor. Study Design: Case control study. Setting: Gynecological and obstetricward of Liaquat University of Medical and Health Sciences Hospital, Hyderabad. Period: 14 Feb2012 to 13 Feb 2013. Study Population: All the Pregnant women at term or post term admittedin gynae ward from 14th February 2012 to 13th February 2013. Results: 100 women recruitedin the study, study carried out at Gynecological ward of Liaquat University of Medical and HealthSciences Hospital Hyderabad. Analysis of booking status listed in Table-I revealed that 68% (n= 68) were un-booked having no antenatal care and 32.0% (n = 32) were booked. There wereno protocol violation, relation to the parity listed in Table-II showed maximum number of patients(n = 62) 62.0% Primigravida and (n = 38) 38.0% multigravidas were include. Age distributionis listed in Table-III maximum patients (n = 49) 49.0% at age between 26 - 35 years, 35 (35.0%)were between 20 - 25 years, 10 (10.0%) were >35 years and 06 (6.0%) patients were belong toless than 20 years. Regarding the gestational age 57 (57.0%) patients in our study presentedbetween 37 - 39 weeks of gestation. However, 47 (47.0%) patients were at 40 - >40 weeksof gestation showed in the (Table-IV). Indication for cervical ripening and induction of laboris listed on Table-V commonest indication was pregnancy induced hypertension followed byprolonged pregnancy, and IUGR etc. Table-VI shows the Bishop score 30 (30.0%) had BishopScore 2 – 3, while 70(70.00%) had a bishop score 4-5. Table-VII shows induction-deliveryinterval, Greater number of women (66/100) delivered within 24 hours of start of induction.Table-VIII showed mode of delivery, majority of the women had normal vaginal deliveries 64.00while 16 deliveries by assisted vaginal deliveries while in remaining 20 cases caesarean sectiondone. Table-IX shows four babies had an Apgar score 4/10 at end of 1 min and 7/10 at end of5 min, whereas 96 babies had an Apgar score of 9/10 in 1 min. The indications for caesareansection are shown in Table-X. There were 09(9%) cases of failed induction, 11 cases of a fetaldistress (Meconium stained liquor). There was no increased incidence of neonatal sepsis orChorioamniotis or puerperal sepsis in any of our patients. No perinatal morbidity or mortalityor any severe maternal complications were noted while mild side effects were noted which ismentioned in (Table-XI). Conclusion: In developed countries prostaglandin E2 are widely usedfor ripening of unfavorable cervix in induction of labor but patient response vomiting, diarrhea,tachycardia, and fever are commonly observed minor side effects. Induction with Prostaglandinreduced the rate of pregnancies progressing beyond 41 weeks and related feto-maternalmorbidity and mortality. After excluding contra indication all women should be offered inductionat 41 completed weeks. Induction with prostaglandin with medical disorder like preeclampsia issafe and better feto maternal outcome.

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