scholarly journals Oxytocin versus Misoprostol used as an induction of labour in term in early rupture of Amniotic membranes

2020 ◽  
Vol 9 (3) ◽  
pp. 1023
Author(s):  
Jaydeep J. Bhatu ◽  
Ankita B. Chaudhari ◽  
Nilesh R. Chauhan
Keyword(s):  
Room Temperature ◽  
Well Being ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Induction Agent ◽  
Safety And Efficacy ◽  
Significant Difference ◽  
Misoprostol Group ◽  
Amniotic Membranes ◽  
Rule Out

Background: Pre labor Rupture of membranes is a common obstetrical problem, significant event as it transforms an ordinary pregnancy into a high risk one. Majority of cases of PROM - of about 60% occur after 37 completed weeks Induction of labour is artificial. Misoprostol is receiving attention as a cervical modifier and labour induction agent. This study compares the safety and efficacy of Misoprostol with Oxytocin in labour induction in term pre labour rupture of membranes. Objective of this study was to compare the safety and efficacy of Misoprostol with that of Oxytocin in labour induction in PROM. The effects were compared between primipara and multipara in a selected sample.Methods: General condition is assessed by pulse rate, blood pressure, height, weight with particular attention to pedal odema, anemia. Cardiovascular and respiratory systems were examined, rule out cephalo pelvic disproportion and for Bishop’s scoring. USG for foetal maturity, Liquor status and for foetal well-being. Admission CTG.Results: There is no significant difference was observed between two groups either in vaginal delivery or in incidence of LSCS. Mean induction delivery interval in misoprostol group for nullipara is 8.5 hours. For multipara it is 6.6 hours. And in oxytocin group for nullipara is 10:4 hours. In multipara it is 6.5 for primipara it was significantly reduced in misoprostol group compared to syntocinon group.Conclusions: Misoprostol is an effective, cheap, safe, stable at room temperature and easy to use if it is used in appropriate dosage for induction of labour in pre-labour rupture of membranes at term.

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.

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 A comparative study of intracervical foley’s catheter with oxytocin and vaginal misoprostol for induction of labour

2020 ◽  
Vol 9 (9) ◽  
pp. 3660
Author(s):  
Priyanka . ◽  
Shashi Bala Arya ◽  
Mirdu Sinha ◽  
J. K. Goel
Keyword(s):  
Pregnant Women ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Bishop Score ◽  
Misoprostol Group ◽  
Successful Induction ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Foley’S Catheter ◽  
Group B

Background: Induction of labour implies stimulation of uterine contraction before spontaneous onset of labour with or without ruptured membranes. Aim of this study was to compare the efficacy and safety of intracervical Foley’s catheter with oxytocin and vaginal misoprostol for labour induction at term.Methods: A total 100 term pregnant women were chosen with bishop score <6 and divided into two groups: Foley’s catheter with oxytocin (Group A) and vaginal misoprostol (Group B). In Group A, a 16 F Foley’s catheter introduced beyond internal os and traction applied every 4 hourly to check for expulsion with simultaneous oxytocin infusion (2 mU/min up to 32 mU/min). In Group B, 25 mcg misoprostol administered every 4 hourly (maximum 6 doses or 150 mcg). Data analysed using SPSS software 20.0. A p value <0.05 was considered statistically significant.Results: No statistical difference found between demographic variables between two groups. Both primigravida and multigravida had poor pre-induction bishop score in both groups. Foley’s catheter (80%) and misoprostol group (96%) had successful induction and was statistically significant (p<0.05). Foley’s catheter took more time from induction-delivery both in primigravida and post-dated pregnant women. The rate of cesarean in Foley’s catheter group was high (62.5%) including 33% cases with failed induction. Foley’s catheter had less maternal and neonatal complications, less NICU admission as compared to misoprostol (p>0.05).Conclusions: Misoprostol was found better for successful induction, decreases induction-to-delivery interval and increases vaginal delivery as compared to Foley’s catheter but it needs constant supervision in view of hyperstimulation and tachysystole.

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 Neonatal outcome in randomized controlled trial of low dose oral misoprostol in comparison with intracervical Dinoprostone gel for labour induction

2017 ◽  
Vol 7 (1) ◽  
pp. 165
Author(s):  
Savithri D. R. ◽  
Suvarna R. ◽  
Prashanthi Chennupalli ◽  
Akshatha S.
Keyword(s):  
Low Dose ◽  
Neonatal Outcome ◽  
Therapeutic Option ◽  
Controlled Trial ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Oral Misoprostol ◽  
Misoprostol Group ◽  
Dose Oral ◽  
Meconium Staining

Background: Induction of labour is a therapeutic option when the benefits of delivery outweigh risks of continuing pregnancy. There are several agents for induction of labour to achieve better outcome of labour. Acceptable methods for induction are oxytocin infusion, dinoprostone gel, misoprostol and mechanical cervical dilators. Prostaglandins are the preferred choice in unripened cervix. To study the neonatal outcome in induction of labour with low dose oral misoprostol compared with intracervical dinoprostone gel and also to assess occurrence of meconium staining liquor.Methods: One hundred women with single live fetus, term gestation, cephalic presentation, reactive fetal heart pattern and Bishops score <6 were included in the study. They were randomized to receive either 6 doses of 25ug oral misoprostol every 3rd hourly or 0.5ug intracervical dinoprostone every 6th hourly for a maximum of 3 doses. Oxytocin was administered. Fetal outcome was assessed in terms of APGAR score, meconium staining and need for NICU.Results: Meconium stained amniotic fluid was high in misoprostol group (16%) compared to dinoprostone group (8%). NICU admissions were seen in 7 neonates in both groups.Conclusions: Low dose oral misoprostol is a safe method of labour induction. APGAR and NICU admission rates were comparable in both groups. Meconium staining was more in misoprostol group compared to dinoprostone group.

scholarly journals Indications of Labor Induction at Delivery Room of Maternity Teaching Hospital in Erbil City

2021 ◽  
Vol 4 (1) ◽  
pp. 41-19
Author(s):  
Bewar Noori ◽  
◽  
Awaz Saeed ◽  
Keyword(s):  
Antenatal Care ◽  
Teaching Hospital ◽  
Gestational Hypertension ◽  
Delivery Room ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Chronic Hypertension ◽  
Term Pregnancy ◽  
Significant Difference ◽  
Post Term Pregnancy

Background and objectives: Induction of labour means stimulation of contractions before the birth starts spontaneously, with or without ruptured membranes. The most common indications include oligohydramnios, pre-labour rupture of the membranes, high blood pressure during pregnancy, severe fetal growth restriction, post-term pregnancy, and var-ious maternal medical conditions such as chronic hypertension and diabetes. The aim of the study was to find out the different indications of labour and associated obstetrical factors in a local tertiary hospital. Methods: A cross-sectional study was conducted among 120 parturient women who attended a delivery room in the Maternity Teaching Hospital in Erbil City from the period of 2nd June to 2nd October 2020. After reviewing the literature, a questionnaire was pre-pared to obtain socio-demographic data, data related to reproductive characteristic and data related to the indications for labour induction. The data were analyzed using descrip-tive and inferential statistical approaches. Results: The study included 120 patients with the highest percentage of the patients (49.1%) were 16 to 23 years old and more than half of the sample (51.6%) had a post-term pregnancy, gestational hypertension and pre-eclampsia (15%). There were highly significant statistical differences between parity, gestational age and indication of labour induction, and significant differences between gravidity and antenatal care visits and indi-cations for labour induction. Conclusions: The majority of the sample had a post-term pregnancy of 40 and 42 weeks as an indication for induction of labour followed by gestational hypertension and pre-eclampsia, oligohydramnios and pre-labour rupture of membrane. There was a statistical-ly significant difference between the antenatal care visit and parity with the induction of labour.

scholarly journals LABOUR INDUCTION;

2018 ◽  
Vol 21 (05) ◽  
pp. 1070-1074
Author(s):  
Samar Ameen
Keyword(s):  
Vaginal Delivery ◽  
Randomized Study ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Labour Induction ◽  
Large Numbers ◽  
Significant Difference ◽  
Oxytocin Infusion ◽  
Misoprostol Group ◽  
Lactated Ringer's Solution

Objective: To compare the efficacy of misoprostol 50ug (sublingual) incomparison with oxytocin infusion than for induction of labour in cases of PROM (prematurerupture of membrane at term). Design: Prospective randomized study. Setting: Mujahid TrustHospital, Faisalabad. Duration: Conducted from Dec 2006 to April 2008. Methods: Womenwere randomized to receive either 50 microgram of sublingual misoprostol every 4 hours withRinger’s lactate solution or oxytocin infusion 10 lU in one litre of Lactated Ringer’s solution witha sublingual placebo. Main outcome measures: The number of women delivering vaginallywithin 24 hours of labour induction. Results: Fifty two women (83%) in misoprostol group and48 (77 %>) in oxytocin group delivered vaginally within 24 hours [relative risk (RR)1.1. However,the induction to vaginal delivery was significantly shorter in the misoprostol group 15+3.7 hourscompared with the oxytocin group 18+4.1. The incidence of tachysystole was more than threefolds higher in misoprostol than in the oxytocin group (14%) versus 4.3%) RR3.3) but this wasnot statistically significant. There was no significant difference in the incidence of hypertonusor hyperstimulation syndrome, mode of delivery intervention for fetal distress or neonataloutcomes between the two groups. Conclusions: The group of women received misoprostolfor labour induction were found more successful in achieving vaginal delivery in comparativelyshorter time and more acceptable to patients. Further studies on safety with large numbers ofwomen need to be conducted before routine use.

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.

scholarly journals Safety and Efficacy of Misoprostol versus Oxytocin for the Prevention of Postpartum Hemorrhage

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Minoo Rajaei ◽  
Samieh Karimi ◽  
Zohreh Shahboodaghi ◽  
Hamidreza Mahboobi ◽  
Tahereh Khorgoei ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Controlled Trial ◽  
Clinical Settings ◽  
Double Blind ◽  
Safety And Efficacy ◽  
Ringer’S Solution ◽  
Oral Misoprostol ◽  
Significant Difference ◽  
Misoprostol Group ◽  
To Receive

Postpartum hemorrhage (PPH) is the commonest cause of maternal death worldwide. Studies suggest that the use of misoprostol may be beneficial in clinical settings where oxytocin is unavailable. The aim of this study was to compare the safety and efficacy of oxytocin and misoprostol when used in the prevention of PPH. In a double-blind randomized controlled trial, 400 pregnant women who had a vaginal delivery were assigned into two groups: to receive either 20 IU of oxytocin in 1000 mL Ringer’s solution and two placebo tablets or 400 mcg oral misoprostol (as two tablets) and 2 mL normal saline in 1000 mL Ringer’s solution. The quantity of blood loss was higher in the oxytocin group in comparison to the misoprostol group. There was no significant difference in the decrease in hematocrit and hemoglobin between the two groups. Although there was no significant difference in the need for transfusions between the two groups, the patients in the oxytocin group had greater need for additional oxytocin. Results from this study indicate that it may be considered as an alternative for oxytocin in low resource clinical settings. This study is registered with ClinicalTrials.govNCT01863706.

scholarly journals Oral mifepristone as adjuvant to prostaglandin E2 (PGE2) gel for preinduction cervical ripening and induction of labour in third trimester

2017 ◽  
Vol 6 (9) ◽  
pp. 3952
Author(s):  
Jitendra D. Mane ◽  
Sanjay Singh ◽  
Anil Kumar Singh
Keyword(s):  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Control Group ◽  
Study Group ◽  
Third Trimester ◽  
Safety And Efficacy ◽  
Vaginal Deliveries ◽  
Spontaneous Labour ◽  
Unfavourable Cervix

Background: Whenever the intrauterine milieu is not conducive for the foetus and continuation of pregnancy may affect adversely to mother and the fetus, termination of the pregnancy is planned. Objective of this work was to study the safety and efficacy of oral mifepristone as adjuvant to PGE2 gel in pre-induction cervical ripening and induction of labour in third trimester.Methods: 150 patients in third trimester were recruited in this single blind randomized control trial that were planned for delivery with unfavourable cervix. They were randomly allocated into two groups i.e. study group (n = 75) who received Tab. Mifepristone 200 mg orally and control group (n = 75) who received placebo orally. At the end of 48 hours (h), change in the Bishop’s Score was assessed and those with unfavourable cervix or not in labour, were administered PGE2 gel intracervically every 6h, for maximum of 3 doses for pre-induction cervical ripening of cervix. Analysis regarding safety and efficacy of the drug was done with regards to maternal and perinatal outcome.Results: Out of 150 patients, 75 received mifepristone and 75 received placebo. Mean Bishop’s Score showed significant improvement after 48h in study group (R R 5.135, 95% CI 4.78 to 5.48) compared to control group (RR 3.43, 95% CI 3.21 to 3.65). Significant number of women went in spontaneous labour in study group (39 v/s 20) (p - 0.035) in each dose category of PGE2 application. The opportunity to induce labour (with oxytocin) was better in study group in each dose category of intracervical PGE2 gel application. Moreover, lesser number of PGE2 gel was used in study group comparing control group. However, there were no statistical differences in both the groups as far as number of vaginal deliveries and caesearean sections are concerned. Duration of labour in both the groups was same. Neonatal and maternal morbidity was comparable in both the groups.Conclusions: Mifepristone improves Bishops score when given 48 h prior to labour induction along with increased number of spontaneous labour and reduced need for PGE2 gel applications, without increasing maternal or neonatal morbidity.

Sign in / Sign up

Export Citation Format

Share Document