scholarly journals A prospective randomized trial of trans cervical Foley’s with extra amniotic saline infusion versus intra cervical prostaglandin E2 gel for induction of labour setting

2017 ◽  
Vol 6 (12) ◽  
pp. 5613 ◽  
Author(s):  
Sunil Kumar ◽  
Rita D. ◽  
R. M. Desai ◽  
Mohan Kumar K. R. ◽  
Dhanalaxmi .
Keyword(s):  
Prostaglandin E2 ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Saline Infusion ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Post Induction ◽  
The Mean ◽  
Group B

Background: This study evaluated the effectiveness of Extra-amniotic saline infusion (EASI) in comparison with that of intracervical Prostaglandin E2 (PGE2) gel for cervical ripening and induction of labour.Methods: The study conducted in SDM College of Medical College Dharwad, Department of OBG, from December 2012 to November 2013. Consecutive patients with unfavorable cervices requiring pre-induction cervical ripening and induction of labour for various indications were asked to participate in this study. 50 patients (Group A) underwent extra amniotic saline infusion and 50 patients (Group B) underwent PGE2 gel application. Post induction augmentation if required was administered. Labour profile outcomes were compared between the groups.Results: Results were comparable in terms of maternal age, indication for induction in majority of cases, pre-induction Bishop Score, mode of delivery, complications and side effects, neonatal complications, and Apgar Score. The mean post induction Bishop Score was higher in EASI group by an average of 9. The mean duration of augmentation was more in PGE2 group by an average of 2 hrs. The induction delivery interval (IDI) was prolonged by an average of 3.5 hours in PGE2 group.Conclusions: For pre-induction cervical ripening the extra amniotic saline infusion is valid alternative for the PGE2 gel. Both the modes of induction were equally safe and effective in terms of mode of delivery and Apgar Score. EASI, however, had rapid cervical ripening and shorter induction delivery interval.

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.

scholarly journals A Comparative Study of Extra-Amniotic Saline Infusion (EASI), Foley’s Catheter and Prostaglandin E2(PGE2) gel for Pre-Induction Cervical Ripening

2018 ◽  
Vol 1 (2) ◽  
pp. 28-32
Author(s):  
Keshar B. Dhakal ◽  
S. Rai Dhakal
Keyword(s):  
Mode Of Delivery ◽  
Cost Effective ◽  
Saline Infusion ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Delivery Time ◽  
Successful Induction ◽  
The Mean ◽  
Time Changes ◽  
Foley’S Catheter

Introduction: Cervical ripening is essential for successful induction of labor. The aim of the study is to compare the efficacy, safety and cost-effectiveness of extra-amniotic saline infusion, Foley’s catheter and intra-cervical PGE2 gel for pre-induction cervical ripening. Methods: A total 150 women having indications of labor induction were randomly assigned equally into three groups: EASI, Foley’s catheter and PGE2 gel. Eligible full-term pregnancy with Bishop score 4 or less was recruited for the study. Computer generated randomization method and random numbers were used to allocate cases into three groups. Data were analyzed by SPSS. The induction to cervical ripening interval, induction to delivery time, changes in the Bishop Score, mode of delivery and cost were assessed. Results: Majority of the cases was primigravida (67.3%) and the most common indication of induction was postdated pregnancy (72%). The mean time for induction to cervical ripening interval was shorter in Foley’s catheter and EASI than PGE2 (6.92 & 5.69 vs 11.08 (P<0.006). Majority of cases in Foley’s catheter and EASI achieved the Bishop score of 7 or more within 24 hours of induction as compared to PGE2 (88% & 84% vs 54%, P<0.000). The mean induction to delivery time is found shorter in EASI and Foley’s catheter than PGE2 (14.95hrs & 16.84hrs vs 23.18hrs). Conclusions: Foley’s catheter and extra-amniotic saline infusion (EASI) are the most efficacious, cost effective and safe methods of cervical ripening as compared to PGE2 gel.

scholarly journals INDUCTION OF LABOUR;

2014 ◽  
Vol 21 (06) ◽  
pp. 1078-1081
Author(s):  
Rabia Sajjad ◽  
Asma Ansari ◽  
Ayesha Snover
Keyword(s):  
Vaginal Delivery ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Induction Of Labour ◽  
Military Hospital ◽  
Intrauterine Death ◽  
Bishop Score ◽  
Group A ◽  
Group B

Objective: The aim of this study to justify induction of labour at 40 weeks of pregnancy in our population. Design: Quasi experimental study. Place and duration: Combined Military hospital Attock, Obstetric and Gynaecology Department from 1.6.2011 to 1.2.2012. Material and method: 100 patients were selected from outpatient department, and divided into two groups, group A, with 50 patients at 40 weeks and group B with 50 patients at 41 weeks. Booked or unbooked patients with singleton pregnancy with cephalic presentation, were selected by non propability consecutive sampling technique. Pregnancy with previous scar, medical disorder, polyhydramnios, multiple fetal and uterine abnormality and intrauterine death, placenta previa, were ruled out excluded from study. Postdate pregnancy was confirmed clinically by last menstrual period and early dating ultrasound. Patients were clinically followed for fundal height, presentations and FHR. Bishop scoring was done and patients were induced mechanically with cervical foley and vaginal pessary PGE2 according to bishop score. Amniotomy was done at bishop score more than 7. Labour was monitored with full protocol. Same procedure was repeated for group B of 50 patients who were selected according to criteria, for induction of labour at 40 weeks of pregnancy. Maternal and fetal outcome was analysed in term of mode of delivery and APGAR score respectively. Results: Out of 100 patients, 50 patients with age 20 to 35 year, presenting at 40 weeks were included in group A. Spontaneous vaginal delivery was seen in 30 patients (60%), 4 by vaccum(8%), 3 by forcep delivery (6%), 13 patients ended up into emergency LSCS (26%). In group B of 50 women, planned for induction at 41 weeks, emergency cesareans were 23 (46%). MAS was in 9(18%) babies as compared to 2% in group A and, Fetal distress (type 2 dips) were found in 3(6%) cases. Neonatal outcome was assessed with help of APGAR score. Babies delivered with good APGAR were 47 in group A, as compared to 41 in group B. Rate of vaginal delivery was high in group A (74%) induced at 40 weeks. Results were analysed by using SPSS 10 and p-value was found to 0.024. No difference was found in the incidence of fetal outcome with APGAR SCORE 10, and fewer babies were with poor APGAR SCORE and p=0.051. Conclusions: Induction at 40 weeks may reduce perinatal mortality and incidence of MAS. It does not increase risk of caesarean section when compared with induction at or beyond 41 weeks.

scholarly journals Intra-cervical foley’s catheter or PGE2 gel for induction of labour: which one is better: a prospective study

2021 ◽  
Author(s):  
Khushpreet Kaur ◽  
Balwinder Kaur ◽  
Navneet Kaur ◽  
Gagandeep Kaur
Keyword(s):  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Controlled Study ◽  
Group A ◽  
The Mean ◽  
Foley’S Catheter ◽  
Group B

Background: Labour is clinically defined as the initiation and perpetuation of uterine contraction with goal of producing progressive cervical effacement and dilatation. The Foley’s catheter is an effective alternative to prostaglandins for cervical ripening/labour induction. Study was done to compare the efficacy of intracervical Foley’s catheter and PGE2 gel as a cervical ripening agent and to study maternal and fetal outcome in terms of mode of delivery and Apgar score.Methods: This randomized controlled study was conducted in Obstetrics and Gynaecology department, Government Medical College, Patiala. 200 women with indication for induction of labour were enrolled in the study to investigate the efficacy and fetomaternal outcome of induction of labour with intracervical Foley’s catheter comparing with PGE2 gel.Results: The mean age in group A was 24.41±3.37 and in group B was 24.24±3.17 years. The 95% women were induced successfully in group A and 97% were successfully induced in group B. Preeclampsia and postdatism were the most common indications for induction in both groups. The mean induction delivery interval in group A was 15.20±4.53 hours and in group B was 15.86±4.79 hours. 4.21% cases required NICU admission in group A while in group B, it was 5.15% cases.Conclusions: Our study concludes that there is no difference in efficacy between intracervical Foley’s catheter and intracervical PGE2 gel for induction of labour and both methods are complementary to each other.

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 A retrospective comparative study to evaluate the efficacy and safety of mifepristone with misoprostol over misoprostol alone in induction in labor

2018 ◽  
Vol 7 (12) ◽  
pp. 5140
Author(s):  
Reena Sharma ◽  
B. R. Sharma ◽  
Poojan Dogra
Keyword(s):  
Comparative Study ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Efficacy And Safety ◽  
Group A ◽  
The Mean ◽  
Group 2 ◽  
Group B ◽  
Retrospective Comparative Study ◽  
Group 1

Background: The aim is to compare the improvement in pre-induction Bishop’s score, proportion of patients going in labor and induction–delivery interval after using the Misoprostol versus Mifepristone and Misoprostol as cervical ripening and labor inducing agent.Methods: It is retrospective comparative study conducted on 110 women. Women were randomized in group A and in group B of 55 patients in each group. Group A received tab Mifepristone 200 mg orally on day 1 followed by Misoprostol 25 ug after 48 hours and continued 6 hourly till maximum four tablets and group B patients received tablet Misoprostol 25ug and continued 25ug 6hrly maximum 4 doses. Women observed for improvement in Bishop‟s score, induction-delivery interval and requirement of subsequent doses of Misoprostol.Results: Present study concluded that tablet Mifepristone is an efficient cervical ripening and inducing agent of labor as pre-induction Bishop’s score was improved. 36.4%patients went into labor only with tablet Mifepristone. The mean induction-delivery interval was,19±12.2hrs in Group 1 as compare to 13.1±13.0 hrs in Group 2. Mean Bishop’s score observed in Group 1 were 2.5±1.78 and 1.67±1.25 in Group 2. It was observed that there was significant improvement in the Bishop’s score after giving Mifepristone to the patients; mean Bishop’s 24hrs after mifepristone were 4.03±1.80. Repeated dose of Misoprostol required in Group 1 was observed to be higher than group 2 as shown in table 8. Mean misoprostol doses required in group 1 was 2.56±1.15 as compared to 1.71±1.58 in group 2.Conclusions: Mifepristone with Misoprostol reduce the induction delivery interval and more potent in combination for induction of labour as compared to Misoprostol alone.

scholarly journals Intracervical PGE2 gel application for cervical ripening and induction of labour: a clinical study

2019 ◽  
Vol 8 (9) ◽  
pp. 3528
Author(s):  
Shilpa Modi ◽  
Jayalaxmi Mahur ◽  
Shashank V. S.
Keyword(s):  
Low Dose ◽  
Mode Of Delivery ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Pelvic Examination ◽  
Bishop Score ◽  
Single Application ◽  
Uterine Contractions ◽  
Successful Induction ◽  
Labour Room

Background: PGE2 gel (cerviprime) not only helps in cervical ripening but also sensitizes the uterine musculature to physiological PGE2 for generation and maintenance of uterine contractions. In the present study the efficacy of PGE2 intracerival gel for ripening and induction of labour has been reported.Methods: This is a randomized prospective study of 80 cases admitted to the labour room during period of 2 years i.e. March 2017 to March 2019 in Department of Obstetrics and Gynecology, KBNIMS, Gulbarga, Karnataka. All patients had clear indications for termination of pregnancy. The initial bishop score determined prior to induction by pelvic examination. Under aseptic precautions PGE2 endocervical gel was instilled. The results analyzed for successful ripening, induction delivery interval, results in primigravida and multigravida with single instillation or reinstallation if required, mode of delivery and maternal and perinatal complications.Results: The present study of 80 cases showed that a single application of intracervical PGE2 gel caused favorable changes in cervix by increasing Bishop score and shortened induction delivery interval with minimal side effects. Successful ripening with single application was achieved in 92.5% of cases (primi 42.5% and multi 50%). Only 6.25% of primi's and 1.25% of multi’s required reinstallation of PGE2 gel. Successful induction was achieved in 47.5% primi's and 50% multi’s i.e. 97.5% cases.Conclusions: The study concludes that single low dose intracervical PGE2 (cerviprime) gel proved to a safe, reliable and effective method for cervical ripening and induction of labour.

scholarly journals Vaginal Prostaglandin E2 pessary versus gel in induction of labor at term

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Humaira Akram ◽  
Zohra Khan ◽  
Tabinad Rana
Keyword(s):  
Cost Effectiveness ◽  
Side Effects ◽  
Prostaglandin E2 ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Bishop Score ◽  
Vaginal Pessary ◽  
Number Of Patients

Objective: To compare the prostaglandin E2 Vaginal pessary and gel with respect to cervical ripening, labour out come, side effects and cost effectiveness in induction of labour at term. Design: Experimental study. Place and duration of study: Lady Willingdon Hospital, Lahore February to July, 2005. Subjects and Methods: The trial was conducted on two group of patient for labour induction such that one group (n=30) received PGE2 vaginal pessary 6 hourly to maximum of 3 doses. Other group (n=30) received PGE2 gel at 6 hourly interval upto 2 doses. Labour induction, number of doses applied, need of augmentation, side effects, induction to delivery interval, mode of delivery, neonatal outcome and cost effectiveness were the main outcome measures. Results: Our results depicted that PGE2 gel produced favourable bishop score more rapidly and initiating uterine contraction simultaneously than PGE2 pessary. Few patients required oxytocin augmentation in gel group (P<0.05). There was no statistically significant d ifference in number of patients delivering vaginally with in 24 hours, the neonatal outcome and cost effectiveness in two groups (P>0.05). However, more side effects such as uterine contractions, abnormalities, and fetal distress observed in gel group (P<0.05). Conclusion: The PGE2 pessary was safe and easily applied, but PGE2 intracervical gel was more effective as it achieved greater changes in mean bishop score. However, more side effects encountered with gel category.

A COMPARATIVE STUDY OF 25 MICROGRAMS VERSUS 50 MICROGRAMS OF INTRAVAGINAL MISOPROSTOL FOR CERVICAL RIPENING AND INDUCTION OF LABOUR (IOL)

2021 ◽  
pp. 65-69
Author(s):  
Rama Garg ◽  
Rupali Tandon
Keyword(s):  
Single Dose ◽  
Comparative Study ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Induction Of Labor ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Chi Square ◽  
Northern India ◽  
Group B

Background- Misoprostol is a safe drug and increasing the dose needed to be tried for decreasing Induction- delivery- interval (IDI). ObjectivesTo compare 25µG versus 50µG of intravaginal Misoprostol for cervical ripening and induction of labor (IOL). Methods- A prospective observational comparative study was done in the Department of Obstetrics & Gynecology of a tertiary institute of northern India from January 2018 to June 2019. One hundred pregnant women with Bishop's Score <6 for induction of labour were randomized : Group A (50 Odd No.) Tab.25µG Misoprostol pervaginum and Group B ( 50 Even No.) Tab.50µG Misoprostol pervaginum. In both groups, a thorough history, physical and obstetrical examination including Bishop's score was done. The same dose was repeated 4 hourly with monitoring the progress of labor and FHS. Number of doses required, induction-delivery- interval, need for oxytocin augmentation, mode of delivery, complications and fetal outcome were recorded. Statistical Analysis: by using chi-square, one sample t-test between percents, and McNemar test on Epi Info 7.2.31.Results- Both groups were comparable for all the outcome variables. (P>0.05.) However signicantly greater number of women delivered with only one dose of 50µG versus 25µG i.e., 40% versus 20% (P=0.008). Also, more women delivered in <12 hours with 50µG (41.86%) than 25µG (22.73%) Misoprostol pervaginum (P=0.016). Furthermore, more women delivered in <12 hours and with only a single dose of 50µG (41.86%) than 25µG(22.73%) Misoprostol pervaginum (P=0.016). Conclusions- 50µG is more effective than 25µG Misoprostol pervaginum in all women for induction of labor especially signicantly more where delivery needs to be expedited like HDPas signicantly more women delivered in <12 hours (P=0.016)with single dose only(P=0.008).

scholarly journals Comparison of Foley’s catheter with PGE2 gel and Foley’s catheter with PGE2 gel with extra amniotic saline infusion for labour induction

2018 ◽  
Vol 7 (5) ◽  
pp. 1782
Author(s):  
Shobha Bembalgi ◽  
Lavanya . ◽  
Vinutha M. B.
Keyword(s):  
Foley Catheter ◽  
Saline Infusion ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Bishop Score ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
Foley’S Catheter ◽  
Group 1

Background: Induction of labour is initiation of uterine contractions before the onset in order to vaginally deliver the foetoplacental unit. Common reasons for induction of labour are post-term and hypertensive disorders of pregnancy. The purpose of this study was to compare the efficacy of Foley catheter with intra cervical PGE2 gel and Foley catheter with PGE2 gel with extra amniotic saline infusion for induction of labour.Methods: The clinical trial was conducted from November 2016 to April 2017 at Karnataka Institute of Medical Sciences, Hubballi. 80 pregnant women which included both primigravidae and multigravidae were alternatively divided into two groups. Group 1 received Foley’s and PGE2 gel and group 2 received Foley’s, PGE2 gel and extra amniotic saline infusion for induction of labour.Results: Both groups were comparable with respect to maternal age, gestational age and indication for induction. There was no significant difference in the mean pre-induction Bishop score between two groups. In both the groups there was significant improvement in the Bishop score after 6 hours of induction. But progress in group 2 was greater than group 1(P <0.05). The mean time from induction to delivery in group 2 was shorter and was statistically significant(P<0.05). There was no difference in mode of delivery, neonatal and maternal morbidity and mortality between 2 groups.Conclusions: The present study showed that Foley’s with PGE2 gel with extra amniotic saline infusion is better for labour induction though both groups appear to be effective agents.

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