scholarly journals Mifepristone safety and efficacy in preinduction of labor: an observational study

2021 ◽  
Vol 10 (3) ◽  
pp. 1027
Author(s):  
Thota Sai Tejaswi ◽  
Shailaja R. Bidri
Keyword(s):  
Randomized Study ◽  
Late Pregnancy ◽  
Active Phase ◽  
Cervical Ripening ◽  
Control Group ◽  
Study Group ◽  
Uterine Contractility ◽  
Time Duration ◽  
Unfavourable Cervix ◽  
Phase Interval

Background: When the continuation of pregnancy adversely affecting the mother and fetus, termination of pregnancy is planned. Mifepristone as a method of pre-inducing agent in late pregnancy by increasing sensitivity of the uterus to the actions of prostaglandins and increasing uterine contractility. Objective of this study is to know the efficacy of mifepristone as a preinduction cervical ripening and induction of labor.Methods: In this prospective randomized study, 130 pregnant women are included and divided into two groups i.e. study group(n=65), has received tab mifepristone 200 mg and control group (n=65) has not received any drug.  After the end of 24 hours, Bishops score in both the groups are assessed and those not in labor or with unfavourable cervix are administered with intracervical dinoprostone gel every 6 hourlies for maximum of 3 doses or until pregnant woman entered into active labor. Statistical analysis regarding improvement in Bishops score, induction active phase interval, induction delivery interval is observed.Results: After 24 hours, observation in the mean Bishops score has showed significant improvement in the study group (72.33%), when compared to control group (54.58%). % woman has gone into spontaneous labor in study group (61.5%), and in control group (75.4%). Induction to active phase time duration is less in study group with mean (10.53), and in control group (17.4). Induction to delivery time duration is also less in study group with mean (15.100) when compared to control group (22.100). 67.7% of patients has delivered by vaginally in study group, and in control group 41%.Conclusions: Tab. mifepristone 200 mg has a pre inducing agent for cervical ripening, shown better improvement in Bishops score within 24-48 hours and decreases time duration from induction to active phase and induction to delivery.

scholarly journals Efficacy and safety of oral mifepristone for cervical priming and induction of labor in term pregnancy

2018 ◽  
Vol 7 (7) ◽  
pp. 2766 ◽  
Author(s):  
Abhilasha Gupta ◽  
Aruna Verma ◽  
Iti Madan ◽  
Monika Kashyap
Keyword(s):  
Controlled Trial ◽  
Group Versus ◽  
Perinatal Outcomes ◽  
Active Phase ◽  
Cervical Ripening ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Bishop Score ◽  
Term Pregnancy

Background: The objectives of the study was to assess the efficacy of mifepristone in priming the cervix/inducing labor over next 96 hrs in term pregnancy.Methods: In this single blind randomized controlled trial 200 women with term pregnancy beyond 39 weeks and Bishop’ score <6 were randomly allocated into two groups. Tab Mifepristone 400 mg orally was given to women in study group (n=100) and no intervention in control group (n=100). On follow up one case was lost in control group. All women were observed for change in the bishop’s score or onset of labor in next 96 hrs. If Bishop’s score was <6, the choice of induction was left on the clinician/patient.Results: Mean induction to delivery interval, duration of active phase and improved Bishop score were 79.35±53.43 hr, 2.47±1.23 hr, 6.68±1.69 for study group versus 148±65.66 hr, 3.09±1.45 hr, 5.8±2.15  for control group (p value is <0.001) respectively.  Seventy one (71%) women in study group and 39 (39.3%) women in control group delivered vaginally within 96 hrs without any need of augmentation. There were 9 (9%) caesareans in study group and 24 (24.2%) caesareans in control group but no instrumental delivery in both groups. There was no statistically difference in perinatal outcomes between two groups.Conclusions: Mifepristone is an effective drug for cervical ripening and initiation of labor when given in term pregnancy beyond 39 weeks with poor Bishop’s score (<6) and appearing to reduce need for other agent for augmentation of labor.

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.

scholarly journals Role of Dexamethasone in Induction of Labor: (A Randomized Clinical Trial)

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H M Elsayed ◽  
A M Bahaa ◽  
A A Alanwar ◽  
K M Mohamed
Keyword(s):  
Pregnant Women ◽  
Statistical Difference ◽  
Active Phase ◽  
Maternity Hospital ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Control Group ◽  
Significant Statistical Difference ◽  
Phase Interval ◽  
Group D

Abstract Background Labor induction is a common obstetric procedure which is done for many indications. Ripening of the cervix is a complex process involving hormonal, vasodilatory and inflammatory changes. There are broad range of methods for cervical ripening and induction of labor. Aim of the study: to assess the efficacy of intramuscular administration of dexamethasone on the induction delivery-interval in full term women undergoing induction of labor. Patients and Methods This study was carried out between July 2018 and January 2019, at the labor ward of Ain Shams university maternity hospital, a double bind randomized control trial of 80 pregnant women undergoing induction of labor after obtaining the approval of the local ethical committee and a fully-informed written consent. They were randomized into two groups: group D (Dexamethasone group n = 40) and group C (control group n = 40). Results Of 80 pregnant women undergoing induction of labor there were no statistically significant differences between the two groups as regard their age, body mass index, gestational age and bishop score at time of intervention. There was significant statistical difference between the two groups as regard induction-active phase interval (P &lt; 0.05), mean induction-active phase interval in group D was (4.91±.85 hours) while in group C was (5.44±.83 hours). There was no significant statistical difference between the two groups as regard duration of active phase of labor, mean duration of active phase in group D was (4.10±.97 hours) and in group C (4.47±1.20 hours). There was significant statistical difference between the two groups as regard induction-delivery interval (P &lt; 0.05), mean induction-delivery interval in group D was (9.73±.1.52hours) while in group C was (10.70±1.87 hours). There were no statistically significant differences between the two groups as regard duration of 2nd and 3rd stages of labor. Conclusion Single intramuscular injections of 2 ml. (8mg) of dexamethasone before induction of labor seems to shorten induction-delivery interval by shortening the induction-active phase interval.

scholarly journals Activity of Proteolytic Enzymes and Level of Cystatin C in the Peripartum Period

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Anna Cyganek ◽  
Aleksandra Wyczalkowska-Tomasik ◽  
Patrycja Jarmuzek ◽  
Barbara Grzechocinska ◽  
Zoulikha Jabiry-Zieniewicz ◽  
...  
Keyword(s):  
Cystatin C ◽  
Cathepsin B ◽  
Proteolytic Enzymes ◽  
Late Pregnancy ◽  
Control Group ◽  
Study Group ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Peripartum Period

Objectives. The aim of the study was to evaluate the activity of cathepsin B, collagenases, trypsin, and plasmin and concentration of cystatin C in serum of healthy pregnant women in peripartum period.Study Design. The study group included 45 women in uncomplicated pregnancies. Blood samples were collected in four time points. Enzyme activity was measured by spectrofluorometric method. The level of cystatin C was measured using immunonephelometric method.Results. Mean activity of cathepsin B and the level of serum cystatin C were significantly higher in the study group. Collagenase activity was significantly lower in the study group than the control group. No differences in collagenase, plasmin, and trypsin activity on each day of the peripartum period were found.Conclusion. High activity of cathepsin B and increased level of cystatin C are typical for women in late pregnancy. Those levels significantly decrease after delivery which can be associated with potential role of those markers in placental separation. The insignificant changes of cystatin C level in the peripartum period seem to exclude the possibility of using cystatin C as a marker for renal insufficiency in the peripartum period but additional research is necessary to investigate the matter further.

scholarly journals The role of oral mifepristone in pre-induction cervical ripening at term

2019 ◽  
Vol 8 (11) ◽  
pp. 4337
Author(s):  
Uma H. Chourasia ◽  
Mudita Kamlesh Jain ◽  
Juzar I. Fidvi
Keyword(s):  
Placebo Group ◽  
Labor Induction ◽  
Cervical Ripening ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Bishop Score ◽  
The Difference ◽  
Pg E2 ◽  
To Receive

Background: Planned induction of labor is an established part of modern obstetrics and is used as a definite form of treatment where continuation of pregnancy would be detrimental to the health of mother or fetus. The objective of this study was to evaluate the effect of mifepristone in pre-induction cervical ripening and labor induction.Methods: A total of 200 pregnant women at term with Bishop Score 4 or less were selected for this prospective randomized placebo-controlled study. The sample was equally divided into study group to receive 200 mg of mifepristone and control group to receive placebo orally for 2 days. Bishop score was assessed at every 24 hours interval till patient entered in spontaneous labor or 72 hours after 1st dose. Women who did not enter labor spontaneously, labor induction was planned with per vaginal insertion of prostaglandin (PG) E2 analogue, Dinoprostone gel 2.5 mg or PGE1 analogue Tab. Misoprostol 25 µg.Results: Ninety-six subjects in the study group and eighty-one in the control achieved successful ripening of cervix and the difference was statistically significant. Sixty-eight of study group and thirty-nine of placebo group entered in spontaneous active labor within 72 hours. Requirement of oxytocin as adjuvant treatment was significantly lower in the study group. Nineteen women of study group and fifteen of control group delivered within 24 hours, and eighty-one of study group and sixty-two of placebo delivered in 48 hours. The mean induction delivery interval was 35.53±13.67 hours in the study group, whereas it was significantly prolonged in the placebo group 50.49±20.92 hours. Eighty-two subjects of study group and seventy-eight of the control group delivered vaginally, the differences were statistically not significant.Conclusions: Mifepristone was found to be an effective agent for cervical priming prior to labor induction in women at term and significantly reduces the induction delivery interval compared with placebo.

Maternal Outcome with Discontinuation of Magnesium Sulfate immediately Postpartum in Severe Preeclampsia

2017 ◽  
Vol 9 (2) ◽  
pp. 84-87 ◽  
Author(s):  
Imam Bano ◽  
Pramod R Gade ◽  
Yasir Alvi
Keyword(s):  
Magnesium Sulfate ◽  
Primary Outcome ◽  
Randomized Study ◽  
Study Groups ◽  
Maternal Outcome ◽  
Severe Preeclampsia ◽  
Control Group ◽  
Study Group ◽  
Medical College ◽  
Jawaharlal Nehru

ABSTRACT Objective To assess the effectiveness of discontinuation of magnesium sulfate (MgSO4) infusion in patients with severe preeclampsia immediately postdelivery. Materials and methods In a prospective-randomized study, women with severe preeclampsia attending the Jawaharlal Nehru Medical College, Aligarh, India, between January 2013 and September 2014 were enrolled. The inclusion criteria were blood pressure of at least 160/110 mm Hg after 24 weeks and either of the following: Proteinuria (dipstick value. 1), platelet <100,000, and serum transaminase levels twice as normal. Participants were assigned to control and study groups according to the time of enrollment (6-month blocks). All patients received MgSO4 loading dose (4 gm intravenously), followed by maintenance doses (1 gm/hour) until delivery (study group) and 24 hours (control group). The primary outcome was occurrence of convulsions after completion of MgSO4 therapy. Patients with treatment failure were excluded from analyses. Results Analyses included 48 patients in the study group and 43 patients in the control group. No convulsions occurred in either group after the completion of treatment. Conclusion: For women with severe preeclampsia, discontinuing MgSO4 immediately after delivery could effectively prevent convulsions. How to cite this article Anjum S, Gade PR, Garg N, Bano I, Alvi Y. Maternal Outcome with Discontinuation of Magnesium Sulfate immediately Postpartum in Severe Preeclampsia. J South Asian Feder Obst Gynae 2017;9(2):78-81.

scholarly journals ONE-YEAR RESULTS OF BRACING FOR PATELLO-FEMORAL OSTEOARTHRITIS. PROSPECTIVE RANDOMIZED STUDY

2021 ◽  
Vol 29 (3) ◽  
pp. 127-131
Author(s):  
MATHEUS GARCIA LOPES MERINO ◽  
VICTOR MORALE ◽  
GUILHERME PEREIRA OCAMPOS ◽  
MARIA CÂNDIDA MIRANDA LUZO ◽  
OLAVO PIRES DE CAMARGO ◽  
...  
Keyword(s):  
Randomized Study ◽  
Control Group ◽  
Study Group ◽  
X Rays ◽  
Long Term Effects ◽  
Level Of Evidence ◽  
Timed Up And Go ◽  
Anthropometric Measures ◽  
One Year

ABSTRACT Objective: To compare the long-term effects of a brace designed to stabilize the patellofemoral (PF) joint in comparison to a standard neoprene sleeve for the knee with patellar hole in patients with patellofemoral osteoarthritis (PFOA). Methods: 38 patients with PFOA and comorbidities received either a functional PF brace (Study Group, SG) or a neoprene sleeve for the knee (Control Group, CG). Both groups received clinical treatment to OA and comorbidities according to a program from the institution. Patients were evaluated with Western Ontario and MacMaster (WOMAC) and Lequesne questionnaires, 30-second chair stand test (30CST), Timed Up and Go (TUG), anthropometric measures and self-reported physical activity in minutes/week at inclusion, one, three and twelve months after placing the brace. X-Rays were taken to measure the angles. Results: At one year there was more abandonment in the CG without differences in weight and body mass index between groups during the study. The SG maintained improvements in Lequesne and WOMAC total and subsets during the year, whereas the CG returned to baseline values for pain, function and total (p < 0.01). TUG and 30CST results were always better in the study group without any clinically important improvement in both groups. Conclusion: Long-term use of functional brace added to self-management program improves pain and function in patients with PFOA. Level of Evidence II, Lesser quality RCT (eg, < 80% followup, no blinding, or improper randomization).

scholarly journals The Effectiveness of 0.6% Povidone Iodine Eye Drops in Reducing the Conjunctival Bacterial Load and Needle Contamination in Patients Undergoing Anti-VEGF Intravitreal Injection: A Prospective, Randomized Study

2019 ◽  
Vol 8 (7) ◽  
pp. 1031 ◽  
Author(s):  
Michele Reibaldi ◽  
Teresio Avitabile ◽  
Francesco Bandello ◽  
Antonio Longo ◽  
Vincenza Bonfiglio ◽  
...  
Keyword(s):  
Prophylactic Treatment ◽  
Povidone Iodine ◽  
Bacterial Load ◽  
Randomized Study ◽  
Control Group ◽  
Study Group ◽  
Eye Drops ◽  
Injection Needle ◽  
Before And After ◽  
And Control

The study purpose was to assess the efficacy of a preservative-free 0.6% povidone iodine eye drops as perioperative prophylactic treatment for reducing conjunctival bacterial load and the rate of needle contamination in patients undergoing intravitreal anti-vascular endothelial growth factor injection. Enrolled patients were randomized to either the study group (0.6% povidone iodine, three day-prophylactic treatment before the injection) or to the control group (placebo, three day-prophylactic treatment). Conjunctival swabs were obtained before and after the prophylactic treatment in both groups. Intravitreal injections were performed in a sterile fashion. The injection needle and a control needle were collected for microbiological culture. Data from 254 and 253 eyes in the study group and control group, respectively, were analyzed. Bacterial growth from conjunctival swab cultures was significantly lower after 0.6% povidone iodine prophylaxis compared to baseline and to placebo prophylaxis (p < 0.001), showing an 82% eradication rate in the study group. No injection needle showed bacterial contamination in the study group, whereas six needles were culture-positive in the control group (p = 0.015). No serious ocular and non-ocular adverse events were recorded. The 0.6% povidone iodine solution proved an effective treatment in reducing conjunctival bacterial load and risk of needle contamination.

scholarly journals Possibilities of a Combined Biophysical Non-Invasive Fetal Monitoring During Labour in Reducing the Frequency of Operative Deliveries – A Randomized Study

2013 ◽  
Vol 13 (2) ◽  
pp. 20-25
Author(s):  
K Dokus ◽  
K Matasova ◽  
J Visnovsky ◽  
S Dokusova ◽  
J. Danko
Keyword(s):  
Pulse Oximetry ◽  
Controlled Trial ◽  
Randomized Study ◽  
Fetal Monitoring ◽  
Delivery Rate ◽  
Control Group ◽  
Study Group ◽  
Operative Delivery ◽  
Intrapartum Fetal Monitoring ◽  
Fetal Pulse Oximetry

Abstract Objective. The aim of the study was to test the performance and safety of fetal pulse oximetry (FPO) in the management of non-reassuring CTG patterns in labour. Materials. A randomized controlled trial was conducted in 648 women in active labour and pregnancies > 36 weeks with reassuring admission CTG followed by non-reassuring patterns. All women were divided into 2 groups according to the mode of fetal intrapartum monitoring used. In the study group (n=324), women received a combined biophysical fetal monitoring with CTG plus FPO (n=324), while the control group of women had CTG alone monitoring. Main outcome measures were rates of operative deliveries and neonatal outcome. Results. The analysis showed a significant reduction of Caesarean deliveries in the study group receiving a combined fetal monitoring compared to controls (45/324 vs. 67/324; P=0.022). The total operative delivery rate was also lower, but not significantly (92/324 vs. 104/324, P=0.302). No comparative differences were observed in neonatal outcomes, except for 2 controls-group neonates born with pH-UA < 7.1, however completely normal further postnatal course. No such case was encountered in the study group neonates, and no perinatal deaths occurred during the study. Conclusions. A combined biophysical intrapartum fetal monitoring with CTG and fetal pulse oximetry enables safe reduction in Caesarean rate for non-reassuring CTG patterns, however it could not decrease a total operative delivery rate. Condensation: Fetal pulse oximetry safely reduces a Caesarean rate for non-reassuring patterns, but not the overall Caesarean rate.

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