scholarly journals Comparative study of single versus double time application of dinoprostone E2 gel on the induction of labor in term pregnancy and it’s fetomaternal outcomes

2021 ◽  
Vol 10 (8) ◽  
pp. 3186
Author(s):  
Santosh Khajotia ◽  
Manoj Gupta ◽  
Mool Chand Khichar ◽  
Madhuri Sharma ◽  
Kavita Choudhary
Keyword(s):  
Prospective Observational Study ◽  
Bishop Score ◽  
Single Application ◽  
Single Time ◽  
Uterine Contractions ◽  
Fetal Complications ◽  
Group A ◽  
Double Time ◽  
Group B ◽  
Single Versus

Background: Labor is defined as a cascade of effective uterine contractions leading to progressive effacement and dilatation of cervix resulting in the expulsion of the fetus, placenta and the membranes. The aim of the study was to evaluate the effect of single time and double time application of dinoprostone E2 gel and to compare fetomaternal outcomes after single and double application of dinoprostone E2 gel and its complications.Methods: This was a prospective observational study conducted on 200 pregnant females with a period of gestation ≥37 completed weeks between 1st January 2020 to 31st January 2021. Group A included females undergoing single time application of PGE2 gel and in group B, second dose applied after 6 hrs of first dose if there was no improvement in Bishop score. If necessary, oxytocin for augmentation of labor was started only 6 hrs after the last dose.Results: Mean age in group A was 24.38±4.37 years and in group B was 24.02±3.76 years and this difference was not found statistically significant (p>0.05). Majority of cases had vaginal delivery. In group A, 28% cases had LSCS delivery while in group B, 17% cases had LSCS delivery (p>0.05). There was significant increase in mean Bishop score after second dose of PGE2 gel in double application group by 3.24 assessed at 12 hours after induction. Double times application of gel resulted in a smaller number of failed inductions i.e.; 23 out of 100 cases in single application group and 7 out of 100 cases in double application group. Main maternal complication was nausea and vomiting which was 5% cases in group A and 11% cases in group B.Conclusions: Double times application of dinoprostone gel resulted in improved Bishop score, facilitates the process of induction, increased number of successful inductions, shortened application delivery interval and decreased cesarean section rate compared to single application. There was slight increase in maternal and fetal complications with double times application.

scholarly journals Bishop score and labor induction

2002 ◽  
Vol 55 (5-6) ◽  
pp. 189-194 ◽  
Author(s):  
Gordana Radeka ◽  
Aleksandra Novakov-Mikic ◽  
Ljiljana Ivanovic
Keyword(s):  
Clinical Work ◽  
Good Method ◽  
Labor Induction ◽  
Bishop Score ◽  
Vaginal Examination ◽  
Uterine Contractions ◽  
Group A ◽  
Experienced Operator ◽  
Group B

Introduction Induction of labor represents initiation of uterine contractions before their spontaneous onset. The aim of the study was to establish the role of Bishop score in prediction of labor induction in routine clinical work. Material and methods The study was a prospective blind, observational one. All patients had a vaginal examination prior to induction, during which Bishop score was evaluated. The mode of induction was either intravenous infusion of oxytocin or endovaginal prostaglandins. The induction was considered successful if vaginal delivery took place within 24 hours from the onset of induction. Results There were 100 patients, and induction was successful in 74% and unsuccessful in 26%. Mean Bishop score in group A was 5.65 (SD 1.40, 95% CI 5.27 - 6.03), and in group B 4.15 (SD 1.04, 95% CI 3.66 - 4.63) (p < 0.01). Statistical analysis of the area under the ROC curve showed that Bishop score is a good and reliable predictor of the outcome of labor induction (0.816, 95% CI od 0.710 - 0.896), with the best statistical performances at the cut-off value of 5 (sensitivity 65.5% specificity 95%, PPV 97.3%, NPV 50%). Conclusion In our study Bishop score proved to be a reliable and good method for prediction of the outcome of pregnancy if a single, experienced operator evaluates it, with best statistical performances at the cut-off value more than 5 (sensitivity 65.5%, specificity 95%, PPV 97.3%, NPV 50%). The next step would be introduction of more operators, of different skills and experience and subsequent further testing of the method in different conditions.

scholarly journals Effect of Intravenous Phloroglucinol Injections upon duration of Active First Stage of Labor

2020 ◽  
Vol 4 (2) ◽  
pp. 69-71
Author(s):  
Bilqees Akhtar Malik ◽  
Ambreen Shabbir ◽  
Zeb-Un-Nisa ◽  
Asma Ambreen
Keyword(s):  
Controlled Trial ◽  
Military Hospital ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Uterine Contractions ◽  
Multiparous Women ◽  
History Of ◽  
Group A ◽  
Group B ◽  
First Stage Of Labor

Objective: In our part of the world poverty and illiteracy has adversely affected our core objective of pregnancy i.e. healthy mother and healthy child. Exploring the role of a routinely used drug in reducing the duration of labor could be a breakthrough. Present study was planned accordingly to evaluate the effect of phloroglucinol (PHL). Materials and Methods: It was a Randomized controlled trial conducted at Department of Obstetrics & Gynecology, Combined Military Hospital, Bahawalpur from January 2019 to June 2019. This study included 60 cases of age 18 to 40 years, having singleton pregnancy and in active first stage of uncomplicated labor. Patients with history of multiple pregnancies, obstetrical and surgical complications and cardiorespiratory diseases were excluded. The cases were placed randomly into Group A & Group B and given intravenous PHL and a placebo respectively. After this, duration of the first stage of labor was recorded in minutes from when there was 3-4 cm cervical dilatation with regular uterine contractions to complete cervical dilation i.e. 10 cm and descent of the presenting fetal part. Results: Mean duration of active first stage of labor in experimental group A (230.20 ± 52.96 minutes) was significantly higher than that of control group B (345.30 ± 50.57 minutes). Conclusion: This study concluded that intravenous PHL has efficiently reduced the duration of active first stage of labor in these randomly selected nulliparous and multiparous women. PHL is a useful drug serving the purpose of a spasmolytic, analgesic and labor augmentation at the same time.

scholarly journals Study to compare between paperless partogram and modified who partogram in management of labour

2017 ◽  
Vol 7 (1) ◽  
pp. 99
Author(s):  
Veena L Sarojini ◽  
. Sarojini ◽  
Prathima Anagondanahalli ◽  
. Prakash ◽  
. Suchitra
Keyword(s):  
Cost Effectiveness ◽  
Prospective Observational Study ◽  
Data Entry ◽  
User Friendliness ◽  
Learning Time ◽  
Entry Cost ◽  
Group A ◽  
Group B ◽  
Monitoring Progress ◽  
Better Than

Background: Partogram is being used since 1954 when Friedman described it for monitoring progress of labour. The Paperless Partogram proposed by Dr. Debdas is a low-skill method for detection of abnormal labour. The main aim of the study is to know efficacy and user friendliness   of paperless partogram in comparison with WHO partogram in monitoring and management of labour.Methods: It’s a prospective observational study conducted at Vanivilas hospital where 200 women in labour were included. 6 resident doctors in shifts were asked to fill partograms 100 each for paperless (group A) and WHO (group B).Results: Paperless partogram has scored better than WHO partogram in terms of documentation, learning, time for data entry, cost effectiveness and monitoring of labour.Conclusions: In our study paperless partogram was found to be preferred for monitoring of labour.

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 Variable use of amiodarone is associated with a greater risk of recurrence of atrial fibrillation in the critically ill

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
N A Fahmy ◽  
S M Alfawal ◽  
H S Abdelsamie ◽  
A M Hassan
Keyword(s):  
Atrial Fibrillation ◽  
Prospective Observational Study ◽  
P Value ◽  
Loading Dose ◽  
Inclusion Criteria ◽  
Reactive Protein ◽  
Group A ◽  
Group B ◽  
Af Recurrence ◽  
New Onset

Abstract Background Atrial fibrillation (AF) is the most common sustained arrhythmia affecting humans. It is an electrical disturbance that leads to rapid, disorganized, and asynchronous contraction of the atrial muscle. In clinical practice, it accounts for approximately one-third of hospitalizations for cardiac rhythm disturbances. The incidence of AF increases from less than 0.1% per year in those under 40 years old to exceed 1.5% per year in women and 2% per year in men older than 80 years. Aim of the Work: to discuss the effect of variation in amiodarone use (including dosage and duration) on dysrhythmia recurrence in patients with new-onset AF in ICU. Patients and Methods This was a prospective observational study conducted over 6 months, 60 patients who fulfilled inclusion criteria were included in the study divided in two groups according to amiodarone dosage, each group is 30 patients: Group (A): received a loading dose of amiodarone followed by an infusion (1200mg amiodarone). Group (B): received a loading dose of amiodarone not followed by an infusion (300mg amiodarone). Results a significant positive correlation was observed between level of C-reactive protein (CRP) and the rate of AF recurrence. As regard effect of CRP on AF recurrence; in AF recurrent patients, mean is (191±77.3) with range from 15 to 352 which significantly differed from Non-recurrent AF patients, mean is (89±63) with range from 20 to 223 (p value &lt;0.001). AF recurrence was higher in group (B) than group (A),. In group (A) 8 patients had recurrent AF representing 26.7 % and in group (B) 19 patients had AF recurrence representing 63.3% (p value =0.004). Conclusion Patients with new-onset AF in (ICU) who are treated with amiodarone should receive a loading dose, immediately followed by an infusion.

scholarly journals Covid-19 and Co-Infection in Children: The Indian Perspectives

2021 ◽  
Author(s):  
Dibyendu Raychaudhuri ◽  
Mihir Sarkar ◽  
Aniket Roy ◽  
Debapriya Roy ◽  
Kalpana Datta ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Viral Infections ◽  
Severe Disease ◽  
Tertiary Care ◽  
Supportive Therapy ◽  
Appropriate Treatment ◽  
Group A ◽  
Study Population ◽  
Tertiary Care Institution ◽  
Group B

Abstract BACKGROUND AND OBJECTIVES Assessing the co-infections with COVID-19 is crucial to delineate its true clinical impact. Pediatric information in this aspect is limited. Our study aims to analyze the spectrum of co-infections in pediatric COVID-19 patients and determine the clinical as well as laboratory parameters predicting co-infection. METHODOLOGY In this prospective observational study conducted from June to December, 2020 in a single tertiary care institution, data pertaining to demographic, illness and treatment-related variables were analyzed among two subsets of pediatric patients of age 1 month -12 years with RTPCR-confirmed COVID-19 infection-Group A: those with confirmed co-infection and Group B: moderate to severe disease without co-infection. Among Group A, etiology of co-infection was characterized through relevant microbiological examination within 48 hours admission. RESULT Among our study population, 15.03% and 20.6% had co-infections and moderate to severe disease respectively. Among those with confirmed co-infection, 32.5%, 11.6% and 6.97% recorded blood culture, respiratory secretion and CSF growth respectively, the picture being dominated by Methicillin resistant and sensitive Staph. Aureus. Serum serology demonstrated Scrub typhus infection to be most prevalent. Concurrent respiratory viral infections were seen in 11.6%. Children with co-infection had significantly higher morbidity and need for supportive therapy. Predictors of co-infection were localization of infection, Neutrophil count &gt;/= 10 x 109, age specific lymphopenia, CRP &gt; 100 mg/dL and hyper-ferritinemia. CONCLUSION Co-infections are an important factor prognosticating pediatric Covid infection .Their early detection, prompt and appropriate treatment is of paramount importance.

scholarly journals Oxytocin Versus Dinoprostone For Labor Induction in Multiparous Women with Unfavorable Cervix

2020 ◽  
pp. 1
Author(s):  
Gul Nihal Buyuk ◽  
Umit Yasemin Sert ◽  
Zeynep Asli Oskovi kaplan ◽  
Serkan Kahyaoglu
Keyword(s):  
Cesarean Section ◽  
Neonatal Intensive Care ◽  
Daily Practice ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Delivery Mode ◽  
Bishop Score ◽  
Multiparous Women ◽  
Group A ◽  
Group B

<p><strong>OBJECTIVE:</strong> Dinoprostone is a drug of choice in our daily practice for the induction of labor. The aim of our study; to compare the use of oxytocin with dinoprostone (PGE2- Propess©) used in term multiparous pregnant women to ripen the cervix.</p><p><strong>STUDY DESIGN:</strong> A total of 507 patients were included in the study. Group A, consisted of 262 women with term multiparous pregnancy Bishop score ≤6 underwent induction of labor with a vaginal insert containing 10-mg timed-release dinoprostone (Propess© -prostaglandin E2). Group B, consisted of 245 cases of pregnancy with Bishop score ≤6 underwent induction of labor with iv oxytocin and was matched for the patient's age and parity. The following data were recorded: age, gestational age, body mass index, the time from the drug administration to the vaginal labor, delivery mode, indications of induction, cesarean indication, birth weight, Apgar score, and need of neonatal intensive care unit. </p><p><strong>RESULTS:</strong> The primary outcome of the in group B interval from induction to vaginal delivery was similar between the two groups. In group A, 41 patients and in group B, 23 patients had a cesarean section. Cesarean section rate was lower in the oxytocin group (cesarean rate 15.6% versus 9.3%, p&lt;0.05). </p><p><strong>CONCLUSION:</strong> It appears; Dinoprostone ovule increases the cesarean rate in terms, multiparous cases with inappropriate cervical score and does not shorten the duration of delivery. Therefore, the use of oxytocin for cervical ripening in multiparous women may be a more appropriate option.</p>

SPOSAB ABP 501 - A SICILIAN PROSPECTIVE OBSERVATIONAL STUDY OF PATIENTS WITH INFLAMMATORY BOWEL DISEASE TREATED WITH ADALIMUMAB BIOSIMILAR ABP 501

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S59-S59
Author(s):  
Fabio Salvatore Macaluso ◽  
Maria Cappello ◽  
Anita Busacca ◽  
Walter Fries ◽  
Anna Viola ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Observational Study ◽  
Bowel Disease ◽  
Prospective Observational Study ◽  
Treatment Persistence ◽  
Group A ◽  
Inflammatory Bowel ◽  
Abp 501 ◽  
Group B

Abstract Background and Aims There are few clinical data on Adalimumab (ADA) biosimilars in inflammatory bowel disease. Methods SPOSAB ABP 501 is a multicenter, observational, prospective study performed among the cohort of the Sicilian Network for Inflammatory Bowel Disease. All consecutive patients treated with ADA biosimilar ABP 501 from the introduction of the drug in Sicily (February 2019) to February 2020 (12 months) were enrolled to assess its safety and effectiveness. Patients were divided into 3 groups: group A, naïve to ADA and naïve to anti-TNFs; group B, naïve to ADA, previously exposed to anti-TNFs; group C: switched from ADA originator to ABP 501. Results 559 patients (median age 39 years; CD 88.0%, UC 12.0%) were included, with a follow-up time of 403.4 patient-years. Thirty-six SAEs occurred in 36 patients [(6.4% - incidence rate (IR): 8.9 per 100 person-years (PY)]. The IR of SAEs was higher among patients in group A compared with group C (17.4 vs. 4.8 per 100 PY; IR ratio=3.61; p&lt;0.001) and among patients in group B compared with group C (16.4 vs. 4.8 per 100 PY; IR ratio=3.42; p=0.041). Among ADA-naïve patients (group A+B), 188 (85.8%) had a clinical response after 12 weeks, including 165 (75.3%) who achieved steroid-free remission. Higher treatment persistence estimates were reported for patients in group C compared with group A and B (log-rank p&lt;0.001). Conclusions Safety and effectiveness of ABP 501 seem to be overall similar to those reported for ADA originator. Switching from originator to ABP 501 was safe and effective.

scholarly journals Intracervical PGE2 gel application for cervical ripening and induction of labour: a clinical study

2019 ◽  
Vol 8 (9) ◽  
pp. 3528
Author(s):  
Shilpa Modi ◽  
Jayalaxmi Mahur ◽  
Shashank V. S.
Keyword(s):  
Low Dose ◽  
Mode Of Delivery ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Pelvic Examination ◽  
Bishop Score ◽  
Single Application ◽  
Uterine Contractions ◽  
Successful Induction ◽  
Labour Room

Background: PGE2 gel (cerviprime) not only helps in cervical ripening but also sensitizes the uterine musculature to physiological PGE2 for generation and maintenance of uterine contractions. In the present study the efficacy of PGE2 intracerival gel for ripening and induction of labour has been reported.Methods: This is a randomized prospective study of 80 cases admitted to the labour room during period of 2 years i.e. March 2017 to March 2019 in Department of Obstetrics and Gynecology, KBNIMS, Gulbarga, Karnataka. All patients had clear indications for termination of pregnancy. The initial bishop score determined prior to induction by pelvic examination. Under aseptic precautions PGE2 endocervical gel was instilled. The results analyzed for successful ripening, induction delivery interval, results in primigravida and multigravida with single instillation or reinstallation if required, mode of delivery and maternal and perinatal complications.Results: The present study of 80 cases showed that a single application of intracervical PGE2 gel caused favorable changes in cervix by increasing Bishop score and shortened induction delivery interval with minimal side effects. Successful ripening with single application was achieved in 92.5% of cases (primi 42.5% and multi 50%). Only 6.25% of primi's and 1.25% of multi’s required reinstallation of PGE2 gel. Successful induction was achieved in 47.5% primi's and 50% multi’s i.e. 97.5% cases.Conclusions: The study concludes that single low dose intracervical PGE2 (cerviprime) gel proved to a safe, reliable and effective method for cervical ripening and induction of labour.

Effects of Delayed Supine Positioning after Induction of Subarachnoid Block on Post-spinal Hemodynamic Changes Compared to Traditional Subarachnoid Block: prospective observational randomized controlled dose response clinical study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Karim saad Abd Elhalim Moustafa ◽  
Hala Gomaa Salama ◽  
Sherif George Anis ◽  
Rehab Abd Elfattah Abd Elrazik
Keyword(s):  
Blood Pressure ◽  
Supine Position ◽  
Local Anaesthetic ◽  
Prospective Observational Study ◽  
Sensory Level ◽  
Invasive Blood Pressure ◽  
Subarachnoid Block ◽  
Non Invasive ◽  
Group A ◽  
Group B

Abstract Background This is a prospective observational study to examine if the delayed supine positioning after induction of subarachnoid block will be of value in minimizing hemodynamic derangement following subarachnoidblock for knee Arthroscopein the teaching hospital of Misr University for science and technology Methods Fifty healthy patients are undergoing knee Arthroscope under spinal Anesthesia were randomized into 2 groups Group A(immediate supine position after Subarachnoid block) and Group B (delayed supine position after Subarachnoid block by 2.5 minutes) each group includes 25 patients. After the injection of local anaesthetic, Heart rate (HR), non-invasive blood pressure (Systolic Blood pressure (SBP), diastolic Blood pressure (DBP) and mean blood pressure(MBP)) were measured at 3 min intervals for the first 15 min following administration of local anaesthetic, and then every 5 min until completion of the surgical intervention. Results Hemodynamic readings (SBP, DBP, MBP, HR) showed more stability in Group(B) than Group(A), group(A) showed higher anesthetic sensory level but adequate anesthetic sensory level to perform Knee Arthroscope surgery was achieved in group (B) Conclusion Under the conditions of this study delayed supine positioning after induction of SAB for 2.5 minutes is of great value in gaining an adequate level of anesthesia with more hemodynamic stability and less vasopressor need as a management of hypotension compared to the conventional SAB in Knee Arthroscope surgery.

Sign in / Sign up

Export Citation Format

Share Document