scholarly journals A comparative study of single versus repeat instillation of intravaginal prostaglandin E2 gel for induction of labour

2020 ◽  
Vol 9 (11) ◽  
pp. 4482
Author(s):  
Aastha Mashkaria ◽  
Sushma R. Shah ◽  
Ami V. Mehta ◽  
Payal P. Panchal ◽  
Aashka Mashkaria
Keyword(s):  
Prostaglandin E2 ◽  
Vaginal Delivery ◽  
Fetal Outcome ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Repeat Dose ◽  
Uterine Hyperstimulation ◽  
Group A ◽  
Failed Induction ◽  
Group B

Background: The aim of induction was to achieve successful vaginal delivery where continuation of pregnancy is not desirable. Unfavourable cervix is one of the main causes of failed induction. Introduction of intravaginal prostaglandins E2 has revolutionised the method of cervical ripening. More than one dose of prostaglandin E2 (PGE2) gel may be necessary to facilitate cervical ripening and increase the chances of vaginal delivery.Methods: This retrospective study was done to find the efficacy of repeat instillation of intravaginal PGE2 gel and to compare the maternal and fetal outcome between the single instillation group and repeat instillation group. The women who went into labour or achieved cervical ripening with a single instillation of PGE2 gel forms Group A. Those who required repeat instillation of PGE2 gel forms Group B. Both groups were compared for specific parameters.Results: Primigravidas required repeat instillation. Postdated pregnancy was the most common indication for induction of labour. 45.2% of primis required only single dose and 54.8% required repeat dose. About two third (77.8%) of multipara required only one dose and a third of multipara needed repeat dose. In Group A 90.7% had vaginal delivery, 9.3% had Caesarean section. Group B 95.7% had vaginal delivery and 4.3% had Caesarean section.Conclusions: Prostaglandins PGE2 (0.5 mg) gel is recommended to be used intravaginally. We applied 2 doses of intravaginal PGE2, 24 hours apart and no complications like uterine hyperstimulation was seen. There is no increased fetal risk with repeat instillation of intravaginal PGE2 gel.

scholarly journals Mifepristone versus intracervical prostaglandin E2 gel for cervical ripening in primigravid patients at term

2018 ◽  
Vol 7 (3) ◽  
pp. 824 ◽  
Author(s):  
Manoj Kumar Sah ◽  
Saraswati M. Padhye
Keyword(s):  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Human Reproduction ◽  
Cervical Ripening ◽  
Birth Canal ◽  
Significant Difference ◽  
Group A ◽  
Pass Through ◽  
Group B

Background: The cervix has to play dual role in human reproduction. During pregnancy, it should remain firm and closed allowing the fetus to grow in utero until functional maturity is attained while during labour it should soften and dilate, allowing the fetus to pass through the birth canal. Objective of present study was to know and compare the effect of oral Mifepristone with intracervical dinoprostone gel for cervical priming prior to induction of labour at term in an unfavorable cervix of primigravida.Methods: This was prospective randomized comparative study. 100 primigravid patients were included, 50 were placed in each group A and B. Tablet Mifepristone 200mg orally was given in group A patients and intracervical dinoprostone gel induction was done in group B patients. Pre induction Bishop’s score was noted at beginning to compare improvement in Bishop’s score after induction. Mode of delivery and induction to delivery interval in both the groups were studied.Results: After induction with Mifepristone 76% women had successful cervical ripening as compared to 56% with dinoprostone. Rate of vaginal delivery was 70% with Mifepristone and 58% with dinoprostone. There was no significant difference in induction to delivery interval between the groups. Ten percent and 2% belonging to mifepristone and dinoprostone group respectively, required NICU admissions.Conclusions: Mifepristone is more effective than dinoprostone for preinduction cervical ripening as it has high success rate of achieving cervical ripening, however there is no significant difference in the vaginal delivery rate and other maternal and fetal outcome.

scholarly journals Comparative study between transcervical extra-amniotic Foley’s bulb and prostaglandin E2 gel for pre-induction cervical ripening

2020 ◽  
Vol 10 (1) ◽  
pp. 119
Author(s):  
Prajakta Goswami ◽  
Kapil Annaldewar ◽  
Deepali Giri ◽  
Sachin Giri
Keyword(s):  
Prostaglandin E2 ◽  
Vaginal Delivery ◽  
Foley Catheter ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Normal Vaginal Delivery ◽  
Bishop Score ◽  
Group A ◽  
Foley’S Catheter ◽  
Group B

Background: Induction of labor is an artificial initiation of uterine activity before the spontaneous onset of labor with the aim of achieving vaginal delivery. Various pharmacological and non-pharmacological methods have been studied for the purpose.Methods: This randomized prospective study conducted in the Department of Obstetrics and Gynaecology at the Seth V. C. Gandhi & M. A. Vora Municipal General Hospital (Rajawadi Hospital), Mumbai from June 2019 to April 2020. It included pregnant patients admitted to the labor ward for induction of labor. A total 200 women were recruited and randomly allocated to the two study groups fulfilling the following selection criteria. Of these, 100 women were included in Foley's catheter group (group A) and 100 in (group B) prostaglandin E2 (PGE2) group.  Results: The subjects included mainly were of 24-28 years age group. The period of gestation was 37-42 weeks in majority of the women in both the groups. Maximum numbers of women in both groups were primigravidae, being 66% in group A and 70% in group B. Foley catheter proved to be a highly effective pre-induction ripening agent for unfavorable cervix, compared to PGE2 gel, as evident by the mean Bishop score at 12 hours (p<0.05) and by the difference in change of Bishop score over 12 hours (p<0.05) in both groups A and B. Women in both the groups had a high rate of normal vaginal delivery, rate being significantly more in Foley’s group.Conclusions: This study concludes that extra-amniotic Foley’s catheter balloon is an effective, safe, simple, low cost, reversible, non-pharmacological mechanical method of pre-induction cervical ripening.

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 A study to evaluate the efficacy of combined prostaglandins and vaginal estradiol compared to prostaglandin alone in labor induction

2020 ◽  
Vol 9 (3) ◽  
pp. 1153
Author(s):  
Anjana B. ◽  
Saniya Sheikh
Keyword(s):  
Prostaglandin E2 ◽  
Fetal Outcome ◽  
Cervical Ripening ◽  
Obstetrics And Gynecology ◽  
Delivery Time ◽  
Active Labor ◽  
Group A ◽  
Group B ◽  
Spontaneous Onset ◽  
Pge2 Prostaglandin E2

Background: Induction of labor (IOL) is a process where labor is initiated artificially before its spontaneous onset for the delivery of feto placental unit by mechanical or pharmacologic methods.Methods: The present Hospital based prospective randomized comparative study was conducted in the department of obstetrics and gynecology, KLES Dr. Prabhakar Kore Charitable Hospital, Belagavi during the period of January 2015 to December 2015.The selected women were randomized into two groups by simple randomization using an opaque sealed envelope, into either without vaginal estradiol Group A: Group PGE2 - Prostaglandin E2 gel intracervical alone group or Group B: PGE2 + E (Estradiol) - combined Prostaglandin E2 gel intracervical and 50 µg of estradiol tablet intravaginal group.Results: In the present study 65% of the women in group PGE2 required three doses of prostaglandins compared to 23.33% in group PGE2 and estradiol for the cervix to become favorable. In this study there is significantly longer mean interval time noted for induction to cervical ripening (12.88±4.91 versus 8.92±5.07; p <0.001), induction to active labor (16.97±4.93 versus 11.02±4.72; p <0.001) and induction to delivery time (21.97±3.83 versus 13.14±4.98; p <0.001) in group PGE2 compared to combined PGE2 and estradiol group.Conclusions: Thus, vaginal estradiol along with prostaglandins has the potential in cervical ripening and induce labor and in an efficacious way. There is beneficial fetal outcome when combined vaginal estradiol along with intracervical prostaglandin E2 was used.

scholarly journals Comparative study to evaluate the efficacy and safety of oral Mifepristone versus intracervical Dinoprostone gel for induction of labour and their effects on fetomaternal outcome

2019 ◽  
Vol 8 (7) ◽  
pp. 2678
Author(s):  
Anu Pathak ◽  
Saroj Singh ◽  
Shikha Singh ◽  
Rajesh Kumar ◽  
Arpita Tyagi
Keyword(s):  
Fetal Outcome ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Efficacy And Safety ◽  
Uterine Contractions ◽  
Group A ◽  
Oxytocin Augmentation ◽  
Nicu Admission ◽  
Group B ◽  
Control Study

Background: Mifepristone and Dinoprostone are used in inducing labour in pregnancy by acting as cervical ripening drugs. A randomized case control study to evaluate the efficacy, safety and fetomaternal outcome of induction of labour with oral Mifepristone and intracervical Dinoprostone gel was done.Methods: About 300 patients were included after taking informed consent. 150 patients were placed in each group A and B. In group A patients received 200 mg oral Mifepristone tablet and in group B 0.5 mg Dinoprostone gel was given intracervically and 2nd dose was repeated after 6 hours later if adequate uterine contractions were not achieved. A detailed analysis was carried out in both groups regarding efficacy and safety of drugs in terms of necessity of augmentation of labour with oxytocin, induction to delivery interval, fetal outcome in terms of NICU admission.Results: 59.33% cases in Mifepristone group and 72% case in Dinoprostone group required augmentation with oxytocin. Mean induction delivery interval in Mifepristone group in primigravida was 17.998±1.128 hrs and mean induction delievery interval in multigravida was 11.648±1.112 hours. 88% cases in mifipristone group and 80% cases in Dinoprostone group delivered vaginally. NICU admission was 1.33% in Mifepristone group and 2.66% in PGE2 gel group.Conclusions: Mifepristone when compared with intracervical Dinoprostone gel, acts as a better cervical ripening agent and requires lesser need for Oxytocin augmentation. Though, mean induction delivery interval was more with Mifepistone, the incidence of successful vaginal delivery was higher as compared to Dinoprostone.

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 Oral and vaginal route of misoprostol for induction of labour: a comparative study

2019 ◽  
Vol 8 (5) ◽  
pp. 1956
Author(s):  
Deepti D. Sharma ◽  
Kavita A. Chandnani
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Induction Of Labour ◽  
Vaginal Route ◽  
Oral Misoprostol ◽  
Group A ◽  
The Mean ◽  
Vaginal Misoprostol ◽  
Group B ◽  
To Receive

Background: Induction of labour can be defined as “Artificial initiation of uterine contractions before the onset of spontaneous labour, after the period of viability, by any methods, for purpose of vaginal delivery.” The key factor for a successful induction is the status of cervix, its form, consistency and dilatation which is determined by the Bishop score. In case of unfavourable cervix or in the pregnancies remote from the term; prostaglandins are more effective than any other method of induction. Introduction of misoprostol, PGE1 analogue, for the induction of labour in 1993 and its approval for clinical use by ACOG (American College of Obstetrics and Gynecology) in 1999 has been the most significant advancement. It is the latest drug for induction of labour which is cheap and stable at room temperature and is being used worldwide in different doses and by various routes. We compared the most commonly preferred two routes; vaginal and oral in terms of success of induction and noted the adverse events and side effects in both routes.Methods: This was a prospective comparative study carried out at SBKSMIRC (Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre), Dhiraj general hospital, Vadodara, Gujarat, 200 patients who required induction of labour were recruited after applying inclusion and exclusion criteria and were randomly divided in two groups- Group A meant to receive 50µg oral misoprostol, Group B - meant to receive 25µg vaginal misoprostol repeated 4 hourly up to maximum of five doses. Progress of labour was charted on the partograph. The mean induction delivery interval, mode of delivery, maternal and neonatal outcomes and complications were observed.Results: The mean induction to delivery interval was significantly less in vaginal group than oral (23.3±12.4 hours in oral vs. 17.3±10 hours in vaginal). Vaginal delivery and cesarean section rates were comparable in both groups (76% in Group A vs. 72% in Group B for vaginal delivery, 18% vs. 20% for Cesarean section, respectively). 58% patients in Group A required more than two doses as compared to 39% in group B, though the difference was statistically not significant. Significant number of patients required added oxytocin administration in Group A (72%). No major complications or adverse events were observed. Neonatal hyperbilirubinemia was seen more in Group A.Conclusions: Both Oral misoprostol in a dose of 50μg and vaginal misoprostol 25 μg every four hours, to a maximum of five doses, have the potential to induce labour safely and effectively. The vaginal route however is beneficial in effecting delivery in lesser time with few numbers of doses as compared to oral route.

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 A comparative study of induction of preterm vaginal delivery at 20 to 28 weeks gestation in previous one lower segment caesarean section by foley catheter and prostaglandin E2 gel

2017 ◽  
Vol 6 (8) ◽  
pp. 3581
Author(s):  
Shruti Agarwal ◽  
Neelam Bharadwaj ◽  
Lata Rajoria ◽  
Indira Lamba
Keyword(s):  
Caesarean Section ◽  
Prostaglandin E2 ◽  
Foley Catheter ◽  
Induction Of Labour ◽  
P Value ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Catheter Group ◽  
Group A ◽  
Group B

Background: The aim of the study to assess the maternal outcome and safety of induced preterm vaginal birth after a previous one lower segment caesarean delivery.Methods: In this study, 100 women who had singleton pregnancies with a previous one term lower segment caesarean section, in whom induction of labour was required in between 20 to 28 wks of gestation, were included. Group A (n= 50) were induced by transcervical foley catheter and group B (n= 50) were induced by prostaglandin E2 gel and then progression of labour was monitored. Both groups were compared in terms of induction delivery interval, efficacy and safety.Results: In our study, all women were delivered vaginally and hysterotomy was not required. The mean induction delivery interval in Foley catheter group (20.180±3.3499 hrs) was significantly shorter (p-value <0.001) than PGE2 gel group B (24.050±3.6537 hrs). There was no case of uterine rupture, puerperal pyrexia, postpartum haemorrhage and uterine hyperstimulation.Conclusions: Women with previous lower segment caesarean section in whom premature induction of labour is required for any reason can be done easily, safely and effectively without maternal morbidity. Induction can be done more effectively by using transcervical foley catheter than intracervical prostaglandin E2 gel. It has shorter induction delivery interval and low complication. Hence, I suggest that every woman with previous one lower segment caesarean section who requires premature induction should go for trial of labour before repeating caesarean section.

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).

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