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.

scholarly journals Efficacy of Dinoprostone Vaginal Pessary for Cervical Ripening and Induction of Labour

2021 ◽  
Vol 10 (12) ◽  
pp. 873-877
Author(s):  
Mamatha C ◽  
Sarmishta M ◽  
Dhanalakshmi M.G
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Active Phase ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Time Interval ◽  
Delivery Time ◽  
Phase Time ◽  
Vaginal Pessary

BACKGROUND To evaluate the efficacy of dinoprostone vaginal pessary for cervical ripening and labour induction in term pregnant women. METHODS This was a prospective observational study conducted at Sri Ramachandra Institute of Higher Education and Research from September 2016 to September 2018. The study included pregnant women with singleton pregnancy and gestational age (GA) between 37 weeks and 41 weeks of gestation. The estimated sample size was 100. All 100 women were induced with dinoprostone vaginal pessary. RESULTS The average induction to active phase interval was 10 hours 58 minutes. About 60.3 % of primigravida had an active phase time interval of 12 hours 03 minutes; and 95.2 % of primigravida delivered < 24 hours with a mean induction to delivery time interval of 17 hours 36 minutes. 4 % of primigravida had failed induction. About 84.8 % of multigravida delivered with mean induction to active phase time interval of 08 hours 57 minutes and 100 % of multigravida delivered < 24 hours with a mean induction to delivery time interval of 12 hours 19 minutes. Out of 100 patients, 80 % of patients delivered by spontaneous vaginal delivery with episiotomy, 5 % of patients delivered by assisted vaginal delivery with episiotomy and 15 % of patients delivered by Caesarean section. Almost 97 % of multiparous women delivered vaginally. No adverse maternal and neonatal outcome was noted in the present study. CONCLUSIONS Dinoprostone vaginal pessary is highly effective in the induction of labour at term in properly selected cases. In terms of success and failure, dinoprostone vaginal pessary does not differ much from dinoprostone gel. KEY WORDS Labour Induction, Propess, Dinoprostone

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.

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 Evaluation of categories of intrapartum fetal heart rate tracings in pregnancies complicated with fetal growth restriction and its relation to perinatal outcome

2021 ◽  
Vol 10 (3) ◽  
pp. 1128
Author(s):  
Bhavya H. U.
Keyword(s):  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Neonatal Outcome ◽  
Strong Association ◽  
Active Phase ◽  
Fetal Hypoxia ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Timely Response ◽  
Normal Outcome

Background: Intrapartum FHR monitoring is widely used during labour as changes in FHR precede brain injury, so timely response to abnormal FHR patterns might be effective in preventing it. There is a strong association between stillbirth and FGR which warrants intensive intrapartum fetal surveillance for optimal perinatal outcome. In this study we aimed to classify intrapartum FHR tracings into different categories in FGR pregnancies and correlate with perinatal outcome.Methods: A total 100 singleton pregnant women >34 weeks gestation with FGR were included in study. FHR tracings were followed throughout first and second stage of labour. FHR tracing were categorized into NICHD 3-tier classification as category I, II and III. Maternal and neonatal outome in each category were analysed.Results: Mean duration of category I tracings was 9.05 hours, category II was 7.66 hours and that of category III was 0.49 hours. During late active phase 25/95 patients with category I FHR tracings had vaginal delivery, 62/95 had category II FHR tracings, of which 95.1% had vaginal delivery and 4.9% had instrumental. 8/95 with category III FHR tracings required caesarean section. All patients with category I tracings had normal neonatal outcome, among patients with category II FHR tracings, 74.6% had normal whereas 25.4% had adverse outcome, all with category III FHR tracings had adverse outcome.Conclusions: Categorizing FHR tracings is helpful to distinguish neonates who are likely to have normal outcome from those who are at risk for fetal hypoxia. When the category II tracings are present, it requires more vigilant monitoring and decision taking.

scholarly journals Vaginal administration of isosorbide mononitrate for cervical ripening prior to induction of labor for postdated pregnancy: a randomized controlled trial

2018 ◽  
Vol 1 (1) ◽  
pp. 51-58
Author(s):  
Rubina Rai ◽  
P Basnet ◽  
A Thakur ◽  
T Pradhan
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Controlled Trial ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Isosorbide Mononitrate ◽  
Oral Misoprostol ◽  
Significant Difference ◽  
Unfavorable Cervix

 Introduction: Induction of labor is commonly practiced intervention in modern Obstetrics. The aim of induction of labor is to initiate labor when maternal and fetal conditions necessitate delivery before the onset of spontaneous contraction with purpose to achieve safe vaginal delivery. Induction of labor is one of the most commonly practiced interventions in the Department of Obstetrics and Gynecology every day. The success of this obstetric practice is highly dependent upon the condition of the cervix which is assessed with Bishop‟s Score and it is well known that unfavorable cervix is associated with failure of induction and cesarean section. In the recent years, there has been a considerable interest in the use of nitrous oxide donors for cervical ripening and labor induction.Objective: To evaluate whether isosorbide mononitrate administered vaginally prior to induction in postdated pregnancy is effective for pre-induction cervical ripening and thus, improves the process of induction of labor.Methods: One hundred and twenty women scheduled for labor induction were recruited and assigned randomly to isosorbide mononitrate or placebo followed by misoprostol 25μg. The efficacy of the medication was evaluated by predetermined outcome variables for cervical ripening and induction of labor and delivery.Results: The groups were comparable with respect to age, gestational age and Bishop‟s score. Women receiving isosorbide with misoprostol didn‟t show any improvement in the Bishop‟s score compared to misoprostol and placebo. There was no significant difference between the two groups regarding time of delivery and onset of active stage of labor from induction. Cesarean delivery rates were similar between the two groups; however, the indications of the cesarean section were different between the two groups which were significant statistically. Neonatal outcome were similar between the two groups.Conclusion: The addition of vaginal isosorbide mononitrate to oral misoprostol for cervical ripening and labor induction did not reduce time to vaginal delivery and didn‟t help in improving pre-induction cervical score.Journal of BP Koirala Institute of Health Sciences, Vol. 1, No. 1, 2018, page: 51-58

scholarly journals Neonatal Outcome among the Misoprostol Induced Term Pregnant women

2015 ◽  
Vol 2 (1) ◽  
pp. 3-6
Author(s):  
Aftabun Nahar ◽  
Afroza Ghani ◽  
Ashia Khatun ◽  
Rifat Sultana ◽  
Fatema Mahbooba Akter ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Apgar Score ◽  
Neonatal Outcome ◽  
Perinatal Death ◽  
Induction Of Labour ◽  
Singleton Pregnancy ◽  
Medical College ◽  
Adverse Result ◽  
Usual Manner

Background: Use of misoprostol in term pregnancy can give some adverse result. Objective: The purpose of the present study was to see the neonatal outcome among the term pregnant women. Methodology: This cohort study was carried out in the Department of Obstetrics and Gynaecology at Sir Salimullah Medical College and Mitford Hospital during the period from 1st September 2005 to 28th February 2006. Primi or second gravida patients with the gestational age between 37 weeks to 42 weeks in singleton pregnancy with cephalic presentation and not in labour who came for delivery purposes during the study period at any age were selected as study population. After proper selection of the cases, induction of labour (IOL) was done by applying Tab Misoprostol 50mcg in the posterior vaginal fornix. Purpose of induction of labour was successful when vaginal delivery occurred without any untoward side effects and without any surgical interference and with good APGAR score of the newborn. Result: A total number of 60 pregnant women were recruited in this study. 60% patients were within 23-30 years of age. This table shows that out of 43 cases of vaginal delivery 22 cases needed 1 dose of Misoprostol 21 cases needed more than 1 dose. This table shows that all the baby were live born. Among them 55 (92%) baby were healthy and 5 (8%) baby were asphyxiated. the depressed babies were well after resuscitation in usual manner and after 5" mean Apgar score was 9.46. Mean birth weight was 2.94 kg. Conclusion: There is no perinatal death in the misoprostol induced delivery; however, neonatal asphyxia is found in few cases as an adverse outcome.Journal of Current and Advance Medical Research 2015;2(1):3-6DOI: http://dx.doi.org/10.3329/jcamr.v2i1.22579

scholarly journals Outcome Of Induction Of Labour By Intravaginal Prostaglandin Versus Intravenous Oxytocin In a Tertiary Care Hospital

2012 ◽  
Vol 17 (2) ◽  
pp. 30-33
Author(s):  
Mst Shahana Pervin ◽  
Shamima Haque ◽  
Jahanara Rahman
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Cost Effective ◽  
Induction Of Labour ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Maternal Complications ◽  
National Medical ◽  
Unfavorable Cervix

Aim of the study was to determine the effectiveness and safety of intravaginal misoprostol VS intravenous oxytocin in induction of labour and to compare the induction delivery interval between prostaglandin induction and oxytocin induction and to detect maternal and foetal outcome between prostaglandin induction and oxytocin induction and also reduce the rate of caesarean section . A prospective, randomized trial was carried out in one hundred singleton pregnant women admitted in Dhaka National Medical Hospital during the period of January 2006 to December 2006. Women who had unfavorable cervix (Bishop’s score<) were selected. 50 of them received 50 mgm misoprostol intravaginally for three doses, 6 hourly. Another 50 patient received intravenous starting from 10 mU /ml up to 40mU.Thirty-nine patients out of 50 patients of misoprostol group achieved normal vaginal delivery. Rest eleven patients ended by caesarean section. 82% of this group delivered within 10 hours. The maximum required dose was 50-150mgm. Maternal complications were PPH 2%. Neonatal outcome were satisfactory. Thirty – six patients out of 50 patients of Oxytocin group achieved normal vaginal delivery. Rest fourteen patients ended by caesarean section. Only 66% of this group delivered within 10 hours. The maximum required dose was 40mU/ml. From the study it was found that intravaginal misoprostol is well tolerated and very effect then intravenous oxytocin in induction of labour in unfavorable cervix. It certainly reduces the number of caesarean section. It is cost effective. DOI: http://dx.doi.org/10.3329/jdnmch.v17i2.12213 J. Dhaka National Med. Coll. Hos. 2011; 17 (02): 30-33

scholarly journals Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110183
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Birth Asphyxia ◽  
Public Hospitals ◽  
Obstructed Labor ◽  
Eastern Ethiopia ◽  
Adverse Neonatal Outcome ◽  
Follow Up Study

The adverse neonatal outcome is defined as the presence of birth asphyxia, respiratory distress, birth trauma, hypothermia, meconium aspiration syndrome, neonatal intensive care admission, and neonatal death. It is a major concern in developing countries, including Ethiopia. This study tried to identify predictors of adverse neonatal outcomes at selected public hospitals in Eastern Ethiopia. A hospital-based prospective follow-up study was conducted in three public hospitals in Eastern Ethiopia from June to October 2020. A total of 2,246 laboring women and neonates born at the hospitals were enrolled in the study. Data were collected through interviews, observation checklists, and clinical chart review. Reports were presented in relative risks with 95% CIs. The overall magnitude of adverse neonatal outcome was 20.97% (95% CI: 19.33- 22.71%). It was 24.3% for babies born through cesarean section (95% CI: 21.3%, 27.5). The presence of meconium in the amniotic fluid increased the risk for neonates delivered via cesarean section (ARR, 1.52 95% CI; 1.04, 2.22). Among neonates born via vaginal delivery, the risk of adverse neonatal outcome was higher among nullipara women (ARR, 1.42 95% CI; 1.02, 1.99) and among women diagnosed with abnormal labor or pregnancy such as APH, pre-eclampsia, obstructed labor, fetal distress, and mal-presentation at admission (ARR, 1.30 95%CI; 1.01, 1.67). The risk of adverse neonatal outcome was higher among babies born through the cesarian section than those born via vaginal delivery. Abnormal labor or pregnancy and being primiparous increased the risk of adverse neonatal outcome in vaginal delivery.

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