scholarly journals Comparison between sublingual 600 and 800 microgram misoprostol after mifepristone for MTP up to 9 weeks gestation

2018 ◽  
Vol 7 (12) ◽  
pp. 4996
Author(s):  
Srishti Thakur ◽  
Charu Pratap
Keyword(s):  
Informed Consent ◽  
Side Effects ◽  
Randomized Study ◽  
Research Centre ◽  
P Value ◽  
Single Center ◽  
Singleton Pregnancy ◽  
Exclusion Criteria ◽  
Obstetrics And Gynaecology ◽  
Sublingual Misoprostol

Background: The objective of the present study was to compare the efficacy between sublingual 600 and 800 microgram Misoprostol after administration of Mifepristone up to 9 weeks gestation, to compare the incidence of side effects between the two doses. To compare the acceptability between the two doses.Methods: This study is a single-center, randomized study. The study is conducted at Fortis Escorts Hospital and Research Centre, Faridabad, during period of May 2014 to June 2015. 160 Pregnant women with singleton pregnancy up to 9 weeks gestation, visiting OPD of Obstetrics and Gynaecology, who wanted MTP by drug, after taking care of inclusion and exclusion criteria. An informed consent was taken from all the women.Results: In terms of efficacy, both the groups were comparable (p value 0.509). Blood loss was comparable in both the groups (p value 0.147). In terms of side effects, itching and rashes (p value 0.004) and abdominal cramps (p value 0.001) was found to be more in women taking 800ug Misoprostol. Also, need for analgesia (p value 0.001) was found to be more in women taking 800ug Misoprostol.Conclusions: Sublingual Misoprostol is comfortable and easier administration when compared to other routes and it has potential to be developed as a self-administered regimen. 600ug Sublingual Misoprostol is as efficacious as 800ug sublingual Misoprostol with significantly lesser side effects up to 7 weeks of gestation.

scholarly journals Comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy at tertiary care centre

2017 ◽  
Vol 6 (6) ◽  
pp. 2395
Author(s):  
Divya Gupta ◽  
Premlata Mital ◽  
Bhanwar Singh Meena ◽  
Devendra Benwal ◽  
. Saumya ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Tertiary Care ◽  
Comparative Assessment ◽  
P Value ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Singleton Pregnancy ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Twin Pregnancies

Background: Multiple pregnancy remains one of the highest risk situations for the mother, foetus and neonate despite recent advances in obstetrics, perinatal and neonatal care. Twin pregnancies have increased rates of obstetric and perinatal complications compared to singletons Objective of present study was comparative assessment of fetomaternal outcome in twin pregnancy with singleton pregnancy in Obstetrics and Gynaecology Department of S.M.S. Medical College, Jaipur.Methods: This was a hospital based, prospective observational study done in the Department of Obstetrics and Gynaecology. S.M.S. Medical College, Jaipur from April 2015 to March 2016. 150 women with twin pregnancy and 150 women with singleton pregnancies at gestation age of 28 weeks and above coming for delivery and consented for the study were included in the study. Women with chronic medical disorder or chronic hypertension were excluded from the study. Maternal and neonatal outcome recorded and analysed.Results: Occurrence of twin in our study was 2.82%. Risk of preterm labour was about nine times higher in twin pregnancies than the singleton (OR: 2.74, 95% CI; 1.4494-5.1884, P value 0.001). The risk of premature rupture of membrane was increased by 2.74 times in twin pregnancies (OR:2.74; 95% CI: 1.4494-5.1884, p value .001). There was 3-time increased risk of malpresentation (OR 3.14; CI:1.7184-5.7480, p value .00002) and 2.28 times increase in hypertensive disorder (OR 2.28; 95% CI: 1.0727-4.8823, p value .03) in twin pregnancies. The risk of asphyxia and septicaemia was 2.5 times more in twins.Conclusions: Twin pregnancy is a high-risk pregnancy with more complications in mother and foetus and is a great challenge for obstetrician. So, it should be managed carefully at tertiary care centre to reduce the maternal and perinatal mortality and morbidity.

scholarly journals Correlation between placental location and development of preeclampsia

2019 ◽  
Vol 8 (11) ◽  
pp. 4155
Author(s):  
Prashaant Uikey ◽  
Vaishali Gurwani ◽  
Megha Tajne
Keyword(s):  
Prospective Study ◽  
Screening Test ◽  
Odds Ratio ◽  
Cost Effective ◽  
Antenatal Clinic ◽  
P Value ◽  
Singleton Pregnancy ◽  
Urine Albumin ◽  
Obstetrics And Gynaecology ◽  
A Prospective Study

Background: Preeclampsia occurs in presence of placenta. Blood supply distribution within the uterus is not similar in central versus lateral sites implicating that, the site of placenta is likely to have a profound effect on the pregnancy outcome. In the light of these observations, a prospective study was designed to find out if the lateral location of placenta as seen by ultrasound between 18-24 weeks of gestation can be used to predict the development of preeclampsia.Methods: This prospective study was conducted in the department of Obstetrics and Gynaecology in IGGMC, Nagpur between January 2017 and June 2018. Pregnant women, with singleton pregnancy and without any risk factor, attending the antenatal clinic were subjected to USG between 18-24 weeks of gestation. Accordingly, patients were divided into 2 groups, 51 with lateral placenta and 51 with central placenta. All 102 women were followed till term. The end point of the study was development of preeclampsia i.e. BP >140/90 and urine albumin >300 mg in 24 hours sample. The data obtained was analysed using appropriate statistical tests.Results: Out of 102 patients, 80.9% were from lateral placenta group and only 19.1% were from central placenta. Sensitivity of this as screening test for preeclampsia was 80.9% while specificity was 58%, Odds ratio being 5.875. In predicting preeclampsia, lateral placenta had a meaningful effect with p value <0.001.Conclusions: Placental laterality, as determined by USG between 18-24 weeks of gestation, is a simple and cost-effective screening test for development of preeclampsia.

scholarly journals Randomized comparison of vaginal and sublingual misoprostol with mifepristone priming in termination of second trimester pregnancy

2019 ◽  
Vol 7 (10) ◽  
pp. 3869
Author(s):  
Shrikrushna Vasant Chavan ◽  
Niraj Nilkanth Mahajan ◽  
Arundhati Gundu Tilve
Keyword(s):  
Side Effects ◽  
Pregnancy Termination ◽  
Medical Abortion ◽  
P Value ◽  
Second Trimester ◽  
Open Label ◽  
Sublingual Misoprostol ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Group B

Background: Sublingual Misoprostol 200 ug 4 hrly is as effective or less effective than vaginal Misoprostol 200ug 4hrly with 200mg oral Mifepristone in termination of second trimester pregnancy.To compare effectiveness, side-effects, and patient satisfaction of sublingual vs vaginal misoprostol administration.Methods: It was prospective randomized open label study. 60 women 13-20 weeks of gestation with a valid legal indication for termination of pregnancy as per MTP act in INDIA were enrolled for study, randomly divided into Group A- Sublingual (n=30) group B-Vaginal (n=30). For group A, 200 mg of Mifepristone was given, 48h later Misoprostol 200 µg was given sublingually 4hrly up to a maximum of 5 doses. If abortion does not occur, the pregnancy was terminated with vaginal misoprostol, in group A. Same procedure repeated in group B. If abortion fails to occur after 5 doses, then second course of vaginal misoprostol was given in group B. Failure of procedure was defined as failed expulsion of foetus at 48 hrs. Results: Mean induction-abortion interval in vaginal group was 12.8±4.38h and 11.47±4.42h in sublingual group was comparable with insignificant p value (p=0.136). All the side effects were comparable in both groups. The overall success rate was 93.3% in the sublingual group while it was 100% in the vaginal group.Conclusion: Vaginal misoprostol with oral mifepristone priming in second -trimester medical abortion has a shorter time to pregnancy termination compared with a sublingual regimen. However, both the routes are equally effective for induction of abortion.

scholarly journals A comparative study between intramuscular oxytocin and intramuscular methyl ergometrine in the active management of third stage of labour

2018 ◽  
Vol 7 (5) ◽  
pp. 1943 ◽  
Author(s):  
Devi Reddy Hema Swapnika ◽  
Prema Priya G. ◽  
S. Senthil Priya ◽  
A. S. Allirathinam
Keyword(s):  
Side Effects ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Active Management ◽  
P Value ◽  
Singleton Pregnancy ◽  
The Third ◽  
Third Stage ◽  
The Difference ◽  
Vertex Presentation

Background: To compare the efficacy of prophylactic IM oxytocin 10U and IM methyl ergometrine 0.2mg on duration of third stage of labour, amount of blood loss during the third stage of labour and associated side effects.Methods: 50 low risk antenatal women with singleton pregnancy at term gestation in vertex presentation admitted for vaginal delivery, were randomly allocated into 2groups of 25 each and managed actively in the third stage of labour either with 10 U oxytocin IM or with 0.2mg methyl ergometrine IM immediately after the birth of the baby. The main outcome measures were the difference between the 2groups with regard to: duration of third stage of labour, blood loss by volume, difference in haemoglobin and haematocrit, need for blood transfusion, additional uterotonics and side effects of drugs.Results: The mean duration of third stage of labour in the oxytocin group was 6.68±2.17min and in methergine group was 6.4±1.93 min. Mean blood loss was 302±75.6ml and 282.8±58.27ml. Mean fall in Hb was 0.92gm% and 0.812gm%. Mean fall in PCV was 2.36% and 1.88%. 2women in oxytocin group and 1woman in methergine group received additional 0.2mg methergine. 3women in both groups received 1unit of blood transfusion. 8women who received methergine had side effects while only one in the oxytocin group, with a p value 0.004 which is statistically significant.Conclusions: This study has shown that both oxytocin and methylergometrine were equally efficacious. However, oxytocin had significantly better safety profile and lesser contraindications for usage.

Randomized comparison of two interventions to enhance understanding during the informed consent process for research

2021 ◽  
pp. 174077452110095
Author(s):  
Holly A Taylor ◽  
Daphne Washington ◽  
Nae-Yuh Wang ◽  
Hiten Patel ◽  
Daniel Ford ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Informed Consent ◽  
Randomized Study ◽  
Informed Consent Process ◽  
Consent Form ◽  
Consent Process ◽  
P Value ◽  
Fact Sheet ◽  
Significant Difference ◽  
Participant Understanding

Background/Aims: Many investigators have tested interventions to improve research participant understanding of information shared during the informed consent process, using a variety of methods and with mixed results. A valid criticism of most consent research is that studies are often conducted in simulated research settings rather than ongoing clinical studies. The present study rigorously tested two simple and easily adoptable strategies for presenting key consent information to participants eligible to enroll in six actual clinical trials (i.e. six parent studies). Methods: In collaboration with the study team from each parent study, we developed two consent interventions: a fact sheet and an interview-style video. The content of each of the intervention was based on the information shared in the consent form approved for each parent study. Participants were randomized to the standard consent process, or to one of the two interventions. Once exposed to the assigned consent mode, participants were asked to complete an assessment of understanding. The study was powered to determine whether those exposed to the fact sheet or video performed better on the consent assessment compared to those exposed to the standard consent. We also assessed participant satisfaction with the consent process. Results: A total of 284 participants were randomized to one of the three consent arms. Assessments of understanding were completed with a total of 273 participants from July 2017 to April 2019. Participants exposed to the video had better understanding scores compared to those exposed to the standard consent form process ( p value = 0.020). Participants were more satisfied with the video when compared to the standard consent. Participants who received the fact sheet did not achieve higher overall understanding or satisfaction scores when compared to the standard consent process. Conclusion: This randomized study of two novel consent interventions across six different clinical trials demonstrated a statistically significant difference in participant understanding based on overall scores among those exposed to the video intervention compared to those exposed to the standard consent.

Combined Spinal–epidural with Levobupivacaine or Ropivacaine with Fentanyl for Labor Analgesia: A Comparative Study

2017 ◽  
Vol 2 (2) ◽  
pp. 73-77
Author(s):  
Malti Agrawal ◽  
Yogesh K Sharma
Keyword(s):  
Side Effects ◽  
Comparative Study ◽  
Randomized Study ◽  
Rapid Onset ◽  
Labor Analgesia ◽  
Singleton Pregnancy ◽  
Double Blind ◽  
Sensory Blockade ◽  
Combined Spinal Epidural ◽  
Spinal Epidural

ABSTRACT Introduction Combined spinal–epidural analgesia to provide pain relief in labor has become the technique of choice. It provides benefits of both spinal analgesia and flexibility of an epidural catheter. In this study, we compared levobupivacaine with fetanyl and ropivacaine with fentanyl in terms of onset and duration of sensory blockade. Materials and methods This was a double-blind randomized study on 60 parturients of American Society of Anesthesiologists status 1 and 2, all primipara with singleton pregnancy in active labor, were allocated randomly into two groups of 30 each. Group L received 3 mg of levobupivacaine intrathecally with 25 µg fentanyl followed by epidural top-ups of 14 mL levobupivacaine 0.125% with fentanyl 30 µg, whereas group R received 4 mg of ropivacaine intrathecally with 25 µg of fentanyl followed by epidural top-ups of 14 mL ropivacaine 0.2% with fentanyl 30 µg. Sensory and motor characteristics, hemodynamics, maternal and fetal outcomes, side effects, and complications were observed and analyzed statistically using Student's unpaired t-test and chi-squared test. Results A rapid onset of analgesia in group L (4.67 ± 0.35) as compared with group R (5.57 ± 0.27) was observed. Duration of analgesia was also prolonged in group B (116.83 ± 6.91) as compared with group R (88.87 ± 5.10). Patients remained hemodynamically stable, and side effects and complications were comparable in both groups. Conclusion Levobupivacaine with fentanyl combination was found to be more promising in terms of onset and duration of labor analgesia as compared with ropivacaine and fentanyl combination. How to cite this article Sharma YK, Agrawal M. Combined Spinal–epidural with Levobupivacaine or Ropivacaine with Fentanyl for Labor Analgesia: A Comparative Study. Int J Adv Integ Med Sci 2017;2(2):73-77.

scholarly journals Effectiveness of Cryokinetics in Comparison with Effectiveness of Ultrasound Therapy in Treatment of Acute Supraspinatus Tendonitis

2021 ◽  
Vol 14 (4) ◽  
pp. 2249-2254
Author(s):  
R. Raja R. Raja ◽  
Varsha Huddar
Keyword(s):  
Analogue Scale ◽  
Therapy Group ◽  
Intervention Group ◽  
Research Centre ◽  
P Value ◽  
Ultrasound Therapy ◽  
Medical Sciences ◽  
Exclusion Criteria ◽  
Repetition Maximum ◽  
Supraspinatus Tendinitis

Aims and Objectives: To compare the effectiveness of Cryokinetics and Ultrasound therapy in treating supraspinatus tendinitis as measured by Visual analogue Scale (VAS) and 1 RM (Repetition Maximum. A sample of 60 patients with acute supraspinatus tendinitis with an experimental comparative study design. Patients who visited out patient department of Kempegowda Institute of Medical Sciences and Research Centre, Bangalore were included in the study based on inclusion and exclusion criteria. Both the groups were treated 5 times per week for three weeks. Patients were evaluated with VAS and 1RM on day 1st, 15th day and end of third week. The values are statistically analyzed to determine their effect in reducing pain and improving muscle strength. Results: The two-intervention group showed significant improvement when the pre and post values were analyzed for VAS and 1RM with significant p value (p<0.05). But inter group comparisons showed cryokinetics group to be more effective (p < 0.05) than ultrasound therapy group for all outcome parameters.

scholarly journals Obesity: A Risk Factor of Preeclampsia

2019 ◽  
Vol 3 (2) ◽  
pp. 104-107
Author(s):  
Wajahat Hussain ◽  
Samina Badar ◽  
Huda Abbas ◽  
Muhammad Imran ◽  
Muhammad Arif Khan ◽  
...  
Keyword(s):  
Risk Factor ◽  
Gestational Age ◽  
Numerical Data ◽  
Outpatient Department ◽  
Categorical Variables ◽  
P Value ◽  
Singleton Pregnancy ◽  
Chi Square ◽  
Cross Sectional ◽  
Obstetrics And Gynaecology

Background: Obesity is a major epidemic of developed world that is now extending to developing countries and is the risk factor of pre-eclampsia which is the major contributor to maternal and foetal morbidity & mortality. Objective: To determine the frequency of preeclampsia in obese primigravida women visiting the Obstetrics and Gynaecology Outpatient Department of Bahawal Victoria Hospital, Bahawalpur, Pakistan. Methodology: This cross-sectional descriptive study was conducted in Obstetrics and Gynaecology Outpatient Department of Bahawal Victoria Hospital, Bahawalpur, Pakistan from January 2018 to December 2018. All the Primigravida women with singleton pregnancy of gestational age ≥ 26 weeks assessed by ultrasound between 20-35 years of age were included in the study by non-probability consecutive method. After obtaining ethical approval from hospital ethical committee and informed written consent from all the study subjects, relevant data were documented in a predefined data sheet and body mass index (BMI) was calculated by using the formula: Weight (kg) / Height2 (m). Women having blood pressure (BP) of 140/90 mmHg or above in third trimester of gestation measured on at least two occasions, 6 hours or more apart accompanied by proteinuria of 300 mg per 24 hours or above in previously normotensive were labelled as preeclampsia and first-time pregnant women having BMI ≥ 30 were taken as obese. Statistical analysis was performed by using computer-based software, Statistical Package for Social Science (SPSS) for windows version 17.0. Mean and standard deviation was calculated for numerical data like age. Frequencies and percentages were calculated for categorical variables. Chi-square test was performed to find the statistical difference regarding preeclampsia distribution between groups and ‘p’ value <0.05 was considered as a lowest level of significance. Results: Mean age of the respondents in the study was 27.08±3.59 years. Majority of the women were between the ages of 26-30 years (53.30%). The mean gestational age of the respondents was 34.50±4.33 weeks and most of the women had gestational age ≥ 36 weeks (46.70%). Frequency of obesity in pregnancy was 15.4% and frequency of preeclampsia in obese primigravida was 55.3%. Conclusion: It is concluded that frequency of preeclampsia is higher in obese primigravida compared to non-obese primigravida.

scholarly journals COMPARATIVE STUDY OF SUBLINGUAL AND VAGINAL MISOPROSTOL TABLET IN MISSED ABORTION

2021 ◽  
Vol 9 (06) ◽  
pp. 623-629
Author(s):  
Raxita Patel ◽  
◽  
Ami Patel ◽  
Debshree a ◽  
Vaishali Panchal ◽  
...  
Keyword(s):  
Side Effects ◽  
P Value ◽  
Missed Abortion ◽  
Significant Incidence ◽  
Sublingual Misoprostol ◽  
Group A ◽  
The Difference ◽  
Vaginal Misoprostol ◽  
Group B ◽  
Abortion Case

Introduction: Management of missed abortion is matter of concern for obstetrician in terms of its methods and complications. Objectives: To compare efficacy, side effects and complications of sublingual and vaginal misoprostol tablet in missed abortion case of less than 20 weeks of gestation. Methods: Total 300 cases were taken, and out of those 300 cases, group A (150cases) included cases who were given sublingual misoprostol tablet, and group B (150 cases) included cases who were given vaginally misoprostol tablet. Observation: Mean gestational age is 7.9 and 8 weeks in Group A and Group B respectively. P value is 0.94. (Not significant). Mean induction abortion interval is 11.6 hours and 12.9 hours in Group A and Group B respectively i.e., the induction abortion interval is slightly short in the Group A. P value is 0.9, means the difference is not statistically significant. Mean dose of misoprostol was 1004.6 microgm and 1080 microgm for group A and group B respectively. P value is 0.029 is significant. Incidence of side effects (nausea, vomiting, unpleasant taste) was higher in group A than group B. P value is <0.05 is significant. Success rate was 86% in group A and 80% in group B. Conclusion: Sublingual and vaginal misoprostol tablet are both equally effective for medical management of missed abortion. Mean dose required for abortion is more in vaginal misoprostol but side-effects are more associated with sublingual misoprostol tablets.

scholarly journals Randomized controlled trial of rectal misoprostal and intramuscular oxytocin in the prevention of PPH

2017 ◽  
Vol 6 (5) ◽  
pp. 1101 ◽  
Author(s):  
Savitha A. ◽  
Sarita H. ◽  
Kashinath Gumma
Keyword(s):  
Blood Loss ◽  
Controlled Trial ◽  
Randomized Study ◽  
P Value ◽  
Singleton Pregnancy ◽  
Risk Pregnancy ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Misoprostol Group ◽  
Uterotonic Agent

Background: PPH accounts for merely 23% of maternal mortality in developing countries.  Misoprostol is a uterotonic agent and is a PGE analogue commonly used in management of PPH. Oxytocin is another uterotonic agent which is now been introduced as intramuscularly effective agent to prevent PPH.This study aims to compare rectal misoprostol with intramuscular oxytocin in reducing blood loss in third stage of labor to prevent PPH. Objective of present study is to compare the clinical effect of rectal misoprostol with intramuscular oxytocin in prevention of PPH.Methods: A randomized study was conducted over duration of 3 months, at Department of OBG, BRIMS, Bidar, Karnataka, India. Patients with singleton pregnancy with the history of one previous LSCS and opting for elective LSCS were included in the study. Patients with risk pregnancy, such as pre eclampsia, cardiac disease and asthma or grand multipara were excluded from the study. Immediately after spinal anesthesia rectal misoprostol was given while oxytocin was administered after delivery of the baby. Incidence of PPH and amount of blood loss was observed and compared.Results: The difference in both the groups with regard to mean amount of blood loss, mean duration of the third stage of labor, and mean amount of fall in hemoglobin level was not statistically significant as P value was >0.05. The incidence of PPH and the need for additional oxytocic are slightly more in the misoprostol group. The incidence of shivering and pyrexia was more in the misoprostol group, but not so disturbing so as to lead to disuse of this drug.Conclusions: Oral misoprostol, though not a replacement of parenterally administered oxytocin, can be used safely in all deliveries for the prevention of postpartum hemorrhage.

Sign in / Sign up

Export Citation Format

Share Document