scholarly journals Comparison of oral, vaginal and sublingual misoprostol for induction of labour in premature rupture of membranes after 34 weeks of gestation: a randomized controlled trial

2018 ◽  
Vol 7 (4) ◽  
pp. 1340
Author(s):  
Chandana Galidevara ◽  
Latha Chaturvedula ◽  
Syed Habeebullah
Keyword(s):  
Apgar Score ◽  
Induction Of Labour ◽  
Delivery Rate ◽  
Labour Induction ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Routes Of Administration ◽  
Active Labour ◽  
Significant Difference ◽  
Sublingual Misoprostol

Background: Purpose of this study was to evaluate the efficacy and safety of different routes of administration of misoprostol - 50µg oral, 25µg vaginal and 50µg sublingual for induction of labour in women with premature rupture of membranes after 34 weeks of gestation.Methods: Women admitted to labour ward with premature rupture of membranes (PROM) after 34 weeks of gestation and requiring induction of labour were randomized into three groups. A total of 246 women participated in the study and were assigned to three groups to receive either 50µg oral misoprostol (n=80) or 25µg vaginal misoprostol(n=83) or 50µg sublingual misoprostol (n=83). The doses were repeated 4 hourly till active labour was established or up to a maximum of 4 doses. Patient factors, induction to delivery intervals, maternal side effects and fetal outcomes were noted.Results: The mean induction to active labour interval was not significantly different in the three groups (oral vs vaginal vs sublingual-7.52±4.8 vs 7.75±4.1 h vs 7.68±5.3 h; p=0.93). There was no significant difference in the induction to delivery time interval among the three misoprostol groups (oral vs vaginal vs sublingual - 10.9± 5.9 h vs 11.2±5.0 h vs 11.4±6.6 h; p= 0.88). Spontaneous vaginal delivery rate, instrumental delivery rate and lower segment ceasarean section rates were comparable among the three groups. The number of neonates with APGAR score <7 (low APGAR) at 1 minute of birth was highest in sublingual group and lowest in vaginal group which was statistically significant (oral vs vaginal vs sublingual, 16% vs 7.2% vs 20.5%; p= 0. 04). APGAR score <7 at 5 minutes was not significantly different among the three groups (oral vs vaginal vs sublingual, 4.8% vs 2.4% vs 7.2%; p=0.2). This implies that the need for immediate resuscitation was more in the sublingual group. Neonatal intensive care admission was least in the vaginal group although the difference was not statistically significant. Sublingual group had a higher rate of hyperstimulation and fetal heart rate abnormalities compared to oral and vaginal groups although these parameters did not reach statistical significance.Conclusions: Oral, vaginal and sublingual routes of administration of misoprostol are equally effective for labour induction in women with premature rupture of membranes after 34 weeks with sublingual route having slightly higher incidence of low APGAR scores at one minute for the neonate.

Induction of labour in term premature rupture of membranes; oxytocin versus sublingual misoprostol; a randomised clinical trial

2017 ◽  
Vol 38 (2) ◽  
pp. 167-171 ◽  
Author(s):  
Leila Pourali ◽  
Nafiseh Saghafi ◽  
Saeed Eslami Hasan Abadi ◽  
Fatemeh Tara ◽  
Atieh Mohamadzadeh Vatanchi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomised Clinical Trial ◽  
Induction Of Labour ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Sublingual Misoprostol

scholarly journals A comparative study between active and expectant management of premature rupture of membranes at term on fetomaternal and perinatal outcome in rural population

2018 ◽  
Vol 7 (6) ◽  
pp. 2393 ◽  
Author(s):  
Rajani Rawat ◽  
Pragati Divedi ◽  
Sukla Debbarma ◽  
Soniya Vishwakarma ◽  
Nupur Mittal
Keyword(s):  
Caesarean Section ◽  
Neonatal Outcome ◽  
Latency Period ◽  
Expectant Management ◽  
Active Management ◽  
Labour Induction ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Management Group ◽  
Significant Difference

Background: Premature rupture of membranes at term (PROM) is defined as a spontaneous rupture of membranes after 37 completed weeks of gestation and before the onset of regular painful uterine contractions. PROM occurs in 5-10% of all pregnancies of which approximately 80% occur at term. The study aimed to compare the maternal and neonatal outcome in patients with term PROM receiving active induction versus expectant management.Methods: The present study was a prospective randomised controlled trial, conducted on 100 term antenatal women with PROM in the Department of Obstetrics and Gynaecology, UPUMS, Saifai from January 2016 to June 2017. 50 antenatal women received immediate induction with oral misoprostol while another 50 antenatal women were expectantly managed for 24 hours. The latency period, PROM delivery interval, maternal and neonatal outcome were compared and subjected to statistical analysis.Results: 42% of active management group and 30% of expectant management group had a latency period of 12-20 hours and results were found to be statistically significant (p value = 0.005). There was no statistically significant difference in the rate of caesarean section, maternal and neonatal morbidity in both the groups.Conclusions: Immediate labour induction in patients with term PROM resulted in significant shortening of latent period and PROM to delivery interval without any increase in caesarean section rate as compared to expectant management group.

scholarly journals Efficacy and safety of intracervical Foley’s in women receiving sublingual misoprostol for induction of labour: a randomized controlled trial

2020 ◽  
Vol 9 (10) ◽  
pp. 4135
Author(s):  
Salini Yadaraju ◽  
Latha Chaturvedula ◽  
Sasirekha Rengaraj
Keyword(s):  
Admission Rate ◽  
Induction Of Labour ◽  
Study Group ◽  
Efficacy And Safety ◽  
Control Groups ◽  
Active Labour ◽  
Mechanical Methods ◽  
Significant Difference ◽  
Sublingual Misoprostol ◽  
And Control

Background: Induction of labour can be carried out by medical or mechanical methods, used alone or in combination. This study is to evaluate the efficacy and safety of intracervical Foley’s in women receiving sublingual misoprostol for induction of labour.Methods: We randomized 230 primi gravidae at ≥37 weeks of gestation, with singleton pregnancy, cephalic presentation requiring induction, with Bishop score ≤4 using block randomization into study and control groups. Both groups received 50 µg sublingual misoprostol every fourth hourly till active labour was achieved or upto a maximum of 6 doses. The study group was induced simultaneously with intracervical Foley catheter.Results: Mean induction to labour interval in study and control groups was 11.191±7.14 hours and 11.758±6.26 hours while mean induction to delivery interval was 17.502±7.93 hours and 18.275±7.66 hours respectively with no significant difference between the groups (p=0.522 and 0.453). More women in study group than in the control (51.3% versus 33.9%) were in active labour within ten hours of induction (p=0.001). Caesarean section rate was 23.5% and 19.1% in study and control groups (p=0.497), the most common indication being foetal distress. Secondary outcomes like foetal heart rate abnormalities, oxytocin requirement were comparable between the two groups. APGAR scores and NICU admission rate were similar in both groups. There was no significant maternal or neonatal morbidity.Conclusions: Though there was no significant reduction in induction to labour or delivery interval with synchronous use of sublingual misoprostol and Foley’s, there was no increase in the complications encountered.

scholarly journals Induced labour with prostaglandin E2 in different parity groups after premature rupture of membranes

2021 ◽  
Vol 9 (3) ◽  
pp. 309-315
Author(s):  
A. A. Sobande ◽  
H. M. Al Bar
Keyword(s):  
Neonatal Intensive Care ◽  
Caesarean Delivery ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Military Hospital ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Hospital Records ◽  
Uterine Hyperstimulation ◽  
History Of

The study compared the outcome of induction of labour with prostagl and in E2 vaginal tablets in patients with premature rupture of membranes [PROM] at term in different parity groups. A retrospective review was made of the hospital records of 169 women attending the maternity unit of King Faisal Military Hospital, Saudi Arabia. There were no statistically significant differences between the 3 groups [parity 0, parity 1-4 and parity 5+] in rates of labour augmentation, caesarean sections, neonatal intensive care admissions or low Apgar scores. There were no serious complications of induction of labour such as infection or uterine hyperstimulation or rupture. Prostagl and in E2 may be used with care for labour induction in women with PROM at term, even gr and ultiparas, unless there is history of previous caesarean delivery

scholarly journals Induction of labour: a randomized controlled trial

2017 ◽  
Vol 6 (6) ◽  
pp. 2512
Author(s):  
Nivedita Reshme ◽  
Rajnish Samal ◽  
Padmaja P ◽  
Shalini S. ◽  
Radhika K.
Keyword(s):  
Clinical Trial ◽  
Mode Of Delivery ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Controlled Clinical Trial ◽  
Bishop Score ◽  
Randomized Controlled ◽  
Active Labour ◽  
Significant Difference ◽  
Foley’S Catheter

ABSTRACTBackground: Clinical trial between Foley’s catheter and Dinoprostone gel for change in Bishop Score after 12 hours of labour induction, mode of delivery, maternofoetal outcome and cost effectiveness. Induction of labour is necessary if the woman does not get timely, adequate and appropriate labour pains. Bishop’s score is used to assess cervical ripening. Hence, we note the change in Bishop Score after 12 hours of labour induction to assess the success rates, time taken for active labour and delivery, maternofoetal outcome and the cost effectiveness.Methods: Block randomized controlled clinical trial between Foley’s catheter and dinoprostone gel for a sample size of 76 in each group was done.Results: In women administered dinoprostone gel, there was significant change in Bishop score with a mean score of 7. Shorter induction active labour interval and induction delivery interval proved it to be a faster inducing agent. No significant difference was noted in terms of mode of delivery. A higher rate of fetal distress was noted in Foley’s group probably as a result of prolonged labour and need for further augmentation with oxytocin for a long duration.Conclusions: In terms of cost of labour Dinoprostone gel though more expensive than the Foley’s catheter, eventually proved to be equally economical for the patients considering the faster labour induction, considerable vaginal delivery rates and hence shorter stay in hospital.

scholarly journals Changes in Umbilical and Cerebral Blood Flow in Pregnancies Diagnosed with Clinical Chorioamnionitis. Is Chorioamnionitis Predictable?

2019 ◽  
pp. 1
Author(s):  
Berfin Okmen Ozkan ◽  
Emre Ekmekci
Keyword(s):  
Umbilical Artery ◽  
Demographic Data ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Significant Difference ◽  
Umbilical Artery Doppler ◽  
Doppler Evaluation ◽  
Umbilical Arteries

<p><strong>Objective:</strong> To evaluate the predictability of clinical chorioamnionitis by Doppler changes in fetal middle cerebral and umbilical arteries, at hospitalized patients due to preterm premature rupture of membranes.</p><p><strong>Study Design:</strong> Patients who were admitted and hospitalized due to preterm premature rupture of membranes between 24 weeks and 33 weeks and 6 days pregnancies are included in the study. Demographic data of patients, gestational age at referring to hospitalization, fetal presentation at admission, delivery time, delivery indications and total follow-up time until delivery of each case were recorded.</p><p><strong>Results:</strong> A total of 108 patients were evaluated retrospectively. The rate of clinical chorioamnionitis was 5.55% (6/108). There was no significant difference between pregnancies terminated with the diagnosis of clinical chorioamnionitis and pregnancies terminated with other indications in terms of the maximum systolic velocity at middle cerebral artery and umbilical artery pulsatility indices.</p><p><strong>Conclusion:</strong> Clinical chorioamnionitis is a serious complication and is more common in patients being followed up after preterm premature rupture of membranes. Although it is crucial to be predicted due to neonatal worse prognosis, it cannot be predicted by middle cerebral and umbilical artery Doppler evaluation.</p>

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

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

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

scholarly journals Evaluation of induction of labour in a tertiary care hospital

2020 ◽  
Vol 9 (4) ◽  
pp. 1361
Author(s):  
Janupalli Kiran Poornima ◽  
Vijayalakshmi K. ◽  
Anuradha C. R. ◽  
Famida . ◽  
Sai Latha R.
Keyword(s):  
Vaginal Delivery ◽  
Apgar Score ◽  
Induction Of Labour ◽  
Delivery Rate ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Normal Delivery ◽  
Operative Vaginal Delivery ◽  
Misoprostol Group ◽  
Oxytocin Augmentation

Background: The objective is to evaluate the preferred methods for labor induction, including incidence of caesarean section, operative and normal vaginal delivery rate, need for oxytocin augmentation, and Apgar score at 1 and 5 min.Methods: This was a hospital-based study carried out in 110 inductions of labour during the study period. misoprostol 50 mcg was inserted in posterior fornix of vaginal in cases with PROM and intracervical 0.5 mg Dinoprostone for other causes in whom induction was decided. Maternal and neonatal outcomes were observed. collected data were analyzed using SPSS and MS excel.Results: Most preferred methods of induction of labour were observed to be Dinoprostone and Misoprostol, augmentation was done by oxytocin. normal delivery rate was 54% in Dinoprostone gel and 58.3% in misoprostol group. Caesarean and operative vaginal delivery rates were 42.8%, 3% in Dinoprostone gel group and 33.3%, 8.3% respectively in misoprostol group. Mean Apgar scores were observed to be similar in both methods of induction at 1st and 5th minutes.Conclusions: It was found that misoprostol had higher percentage of normal and operative vaginal delivery and need for oxytocin augmentation than Dinoprostone. Neonatal outcome as predicted by Apgar score were similar in both groups.

scholarly journals Antenatal Screening for Group B Streptococcus in the Setting of Preterm Premature Rupture of Membranes: Empiric versus Culture-based Prophylaxis

2020 ◽  
Vol 10 (01) ◽  
pp. e26-e31
Author(s):  
Leena B. Mithal ◽  
Nirali Shah ◽  
Anna Romanova ◽  
Emily S. Miller
Keyword(s):  
Multivariable Analysis ◽  
Group B Streptococcus ◽  
Preterm Neonates ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Significant Difference ◽  
Culture Sensitivity ◽  
Intrapartum Antibiotic ◽  
Group B

Abstract Objective Imperfect culture sensitivity and increase of early onset neonatal sepsis (EONS) risk in preterm neonates raise concern that culture-based intrapartum antibiotic prophylaxis (IAP) may be insufficient after preterm premature rupture of membranes (PPROM). Our objective was to compare rates of EONS after empiric versus culture-based IAP in PPROM. Study Design This retrospective cohort study included women with a singleton gestation and PPROM between 23 and 33 weeks. Outcomes after culture-based IAP were compared with empiric IAP. The primary outcome was EONS. Secondary outcomes included group B streptococcus (GBS) bacteremia, bacteremia, and neonatal GBS infection. Bivariable and multivariable logistic analyses were performed. Results Of the 270 women who met inclusion criteria, 136 (50%) had culture-based IAP of whom 36 (26.5%) were GBS positive. There was no significant difference in bacteremia (2.2 vs. 4.5%, p = 0.30), GBS infection (0.8 vs. 0.7%, p = 1.00), or EONS (11.8 vs. 12.7%, p = 0.82) in infants of women with culture-based IAP compared with empiric IAP. Multivariable analysis confirmed a lack of advantage to empiric versus culture-based IAP in EONS risk (adjusted odds ratio [aOR] = 0.82, 95% confidence interval [CI]: 0.44–1.93). Conclusion In pregnancies complicated by PPROM, infants of women who received culture-based IAP had no significant difference in EONS or GBS infection compared with infants of women with empiric IAP.

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