scholarly journals Comparative study of intravaginal misoprostol versus dinoprostone gel for induction of labour in primigravida

2021 ◽  
Vol 10 (11) ◽  
pp. 4194
Author(s):  
Shirish S. Dulewad ◽  
Chitikala Haritha
Keyword(s):  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Vital Signs ◽  
Cost Effective ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Controlled Study ◽  
Tertiary Care Centre ◽  
Misoprostol Group ◽  
Fetal Wellbeing

Background: Labour is an inevitable consequence of pregnancy. The aim of the present research was to study the safety, efficacy and effect of intravaginal misoprostol and dinoprostone gel for induction of labour.Methods: 300 patients who required induction of labour in a tertiary care centre were included in this prospective randomized controlled study from August 2019 to August 2021 with a study duration of 12 months. 50% of cases received 25 µg of intravaginal misoprostol and repeated for a maximum of 6 doses every 4 hours as needed. 50% cases received 0.5 mg dinoprostone gel and repeated for maximum of 2 doses every 6 hours as needed. The patients selected were evaluated initially by modified Bishop’s score and admission test for fetal wellbeing. After drug insertion, patients were monitored for fetal heart rate, vital signs, progress of labour. A partogram was strictly maintained in all patients.Results: The highest number in both groups being below 40 weeks which were 74% and 76% in dinoprostone and misoprostol groups respectively. Rest were between 40.1-41.6 weeks. The mean induction delivery interval in dinoprostone was more (16.15±3.1) than in misoprostol (12.26±2.21). Requirement of oxytocin augmentation was less in misoprostol group than dinoprostone group. Caesarean section rate was less in misoprostol group. Maternal side effects were minimal in either groups and neonatal outcome was good in both the groups.Conclusions: Both misoprostol and dinoprostone gel are safe, effective for cervical ripening and induction but misoprostol is more cost effective and stable at room temperature. 

scholarly journals Comparative study of intra vaginal misoprostol (PGE1) with intracervical dinoprostone (PGE2) gel for induction of labour

2018 ◽  
Vol 7 (9) ◽  
pp. 3769
Author(s):  
Bina M. Raval ◽  
Nainesh S. Zalavadiya ◽  
Pushpa A. Yadava ◽  
Shital T. Mehta
Keyword(s):  
Caesarean Section Rate ◽  
Cost Effective ◽  
Active Phase ◽  
Cross Sectional Study ◽  
Cervical Ripening ◽  
Cross Sectional ◽  
Misoprostol Group ◽  
The Mean ◽  
Vaginal Misoprostol ◽  
Mean Time

Background: Labour is a final consequence of Pregnancy and is inevitable. The timing of labour may vary widely but it will happen sooner or later. The aim of the present research was to study the safety, efficacy and effect of intra vaginal Misoprostol and intra cervical Dinoprostone gel for induction of labour.Methods: 100 patients who required labour of induction were included in this prospective cross-sectional study from September 2017- March 2018. 50 patients of them received 25mcg tablet misoprostol intravaginal and 50 patients of them required 0.5mg intracervical dinoprostone gel and doses were repeated every 6 hourly for up to maximum 6 doses for Misoprostol and 3 doses for Dinoprostone gel.Results: The majority of patients had gestational age above 40 weeks and between 37-40 weeks in PGE2 and PGE1 group respectively. The mean time taken for the onset of labour was less in Misoprostol than in Dinoprostone group (43.22min v/s 1 hr40 min). The mean time taken for induction to active phase of labour (1hr 42min v/s 4hr 10min) and active phase to delivery (3hr 6min v/s 4hr54min) was less in Misoprostol than Dinoprostone group. The mean time required for induction to delivery was less in Misoprostol group (5hr 2min v/s 11hrs). Requirement of oxytocin for augmentation of labour was almost equal in both groups. Caesarean section rate was less in Misoprostol group (10% v/s 22%). Maternal side effects were minimal in either groups and neonatal outcome was good in both the groups.Conclusions: Both Misoprostol and Dinoprostone gel are safe, effective for cervical ripening and induction but Misoprostol is more cost effective and stable at room temperature.

Randomized control trial of low dose oral misoprostol compared with intracervical dinoprostone gel for cervical ripening

2017 ◽  
Vol 7 (1) ◽  
pp. 104
Author(s):  
Savithri D. R. ◽  
Prashanthi Chennupalli ◽  
Suvarna R. ◽  
Akshatha S.
Keyword(s):  
Low Dose ◽  
Therapeutic Option ◽  
Caesarean Section Rate ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
P Value ◽  
Maternal Complications ◽  
Oral Misoprostol ◽  
Misoprostol Group ◽  
Dose Oral

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. Objective of this study was to compare efficacy, safety of low dose oral misoprostol compared with intracervical dinoprostone gel for cervical ripening.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.Results: Bishops score improvement after 6,12,18 hours in both the groups was statistically insignificant. Induction delivery interval was11.96±5.88 for misoprostol and 10.95±4.58 in dinoprostone group with P value 0.341 which was statistically insignificant. Need for oxytocin augmentation was less (18%) in misoprostol group as compared to dinoprostone group (44%). Caesarean section rate was slightly higher in misoprostol group (26% vs 24%). Meconium stained amniotic fluid was high in misoprostol group (16%) compared to dinoprostone group (8%). Maternal complications were minimal and neonatal outcome was good in both the groups.Conclusions: Compared to dinoprostone; misoprostol is easy to store, cost effective, stable at room temperature, can be easily administered and had better patient compliance and acceptability. It was found to be a better cervical ripening agent with similar maternal and fetal safety profile.

scholarly journals Comparative study of misoprostol sublingually and dinoprostone gel intracervically for cervical ripening and induction of labor

2017 ◽  
Vol 6 (8) ◽  
pp. 3624
Author(s):  
Shikha Yadav ◽  
Nootan Chandwaskar
Keyword(s):  
Mode Of Delivery ◽  
Cost Effective ◽  
Active Phase ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Cost Effective Method ◽  
Sublingual Misoprostol ◽  
Misoprostol Group ◽  
Oxytocin Augmentation ◽  
Live Fetus

Background: Both Prostaglandin E1 and E2 analog are being used for cervical ripening. The aims of study was to compare the efficacy and safety profile of sublingual misoprostol (PGE2) and intracervical dinoprostone (PGE1) for cervical ripening and induction of labor.Methods: One hundred women with single live fetus and with gestational age of more than 37 weeks admitted for induction of labor were recruited for the study. Patients were randomized to receive either 25μg of misoprostol sublingually or dinaprostone gel (0.5mg) intracervically.Results: There was shorter induction to active phase, induction to delivery time intervals and less requirement of oxytocin augmentation in misoprostol group than dinoprostone gel group. Incidence of tachysystole was higher in misoprostol group than dinoprostone gel group (22% vs 10%) however this was not statistically significant. Mode of delivery, maternal and neonatal complications were similar in both the groups.Conclusions: Use of misoprostol in lower dose is a safe and cost-effective method for cervical ripening and induction of labor.

scholarly journals A RETROSPECTIVE STUDY ON EVALUATION OF CAESAREAN SECTION RATE USING THE ROBSON’S 10 GROUP CLASSIFICATION IN SARDAR PATEL MEDICAL COLLEGE, BIKANER

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Sudesh Agrawal ◽  
Virendar Singh Rawat
Keyword(s):  
Caesarean Section ◽  
Scientific Evidence ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Group Classification ◽  
Health Concern ◽  
International Studies ◽  
Negative Consequences ◽  
Tertiary Care Centre ◽  
Pregnant Females

Introduction : Despite the lack of scientific evidence indicating any substantial maternal and perinatal benefits from increasing caesarean section rates, most of the studies are showing that higher rates could be linked to negative consequences in maternal and child health, still caesarean rates continues to increase worldwide, particularly in middle and high income countries, and have become a major and controversial public health concern. Therefore, we conducted this study to analyse the LSCS rate in the institute, to classify the indications of LSCS as per RTGCS and to find out strategy to decrease the prevalence of lower segment caesarean section. Material & Methods : This is a retrospective hospital based study at tertiary care centre. Data collection of one thousand pregnant females who delivered by caesarean section from the period of January 2018 onwards was assessed for the study. There are six parameters as per Robson’s classification to classify all pregnant females for caesarean section. Entire information was entered in Microsoft excel sheet and analysis were done to decrease caesarean section rate. Results : In the present study, a total of 1000 pregnant women delivered by caesarean section was taken from January 2018 onwards. The total number of deliveries during this study period was 2919 and the overall caesarean section rate was 34.25%. Most of the patients belonged to Robson’s group 1,2&5 which contributed to 65.6% to total. Conclusion :  The overall CSR in the study is 34.25% which is high as compared to international studies, contribution of repeat CS is high. It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS rate. More analytical studies based on Robson’s 10-group classification system are needed locally, to evaluate the indications of CS within each group.  

scholarly journals Analysis of repeat LSCS in a tertiary care centre

2018 ◽  
Vol 7 (5) ◽  
pp. 1963
Author(s):  
M. Poovathi ◽  
Suilharsini T. S.
Keyword(s):  
Caesarean Section ◽  
Tamil Nadu ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Management Strategies ◽  
Negative Consequences ◽  
Care Needs ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Set Up

Background: Caesarean section (CS) rates continue to increase worldwide, particularly in middle and high-income countries without evidence indicating substantial maternal and perinatal benefits from the increase and some studies showing negative consequences for maternal and neonatal health. The objective of this study is to analyse the repeat caesarean section rates in a tertiary centre.Methods: This is a retrospective study carried out in the Department of Obstetrics and Gynaecology, Pudhukottai Medical College, Tamil Nadu, India for a 12-month period from January 2017 to December 2017 with the aim to analyse the rate and indications for caesarean section and to identify the measures to decrease its incidence if possible. A total of 2654 cesarean deliveries were conducted in one year, out of which 1380 (51.99%) were primary cesarean sections and 1274(48%) were repeat cesarean sections.Results: Repeat LSCS is more common in age group of 21-30 years (80%) and in second gravida (90.42%). The incidence of caesarean section is 94.6%. Patients who had successful trial of scar were 73. In all these patients, measures were taken to shorten the 2nd stage of labour either by giving episiotomy alone or by application of outlet forceps or vacuum. Out of these 62 (84.9%) patients were delivered by episiotomy alone.Conclusions: Caesarean section has become one of the commonly performed surgeries in obstetric practice. Implementation of standard labour management strategies can reduce primary caesarean section rate without compromising maternal and fetal safety. One important strategy is ROBSON ‘S 10 GROUP classification system for caesarean section needs to be adopted. Targets of care needs to be set up which also depends on the available resources and expertise. With continuous critical review as described and frequent comparison with other delivery units, the caesarean section rate in each individual unit can be reduced to an appropriate level.

Concurrent surgeries in ENT: a cost-effective and safe approach in patients requiring multiple definitive procedures

2004 ◽  
Vol 118 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Achamma Balraj ◽  
Mary Kurien ◽  
Anand Job
Keyword(s):  
Surgical Procedures ◽  
Tertiary Care ◽  
Case Series ◽  
Cost Effective ◽  
Definitive Treatment ◽  
Tertiary Care Centre ◽  
Retrospective Case ◽  
Average Hospital ◽  
Duration Of Surgery

Treatment of the predisposing factors that are identified in the nose and throat in several ENT diseases is mandatory prior to the definitive management of the latter. When surgical management is indicated it has been traditional to use staged procedures. This study was undertaken to assess the role of concurrent surgical procedures in ENT and evaluate their cost-effectiveness compared to similar staged procedures. This was a retrospective case series of 100 consecutive patients undergoing concurrent and similar staged ENT surgical procedures. On analysis, it was noted that the average duration of surgery, anaesthesia and hospital stay was significantly less in the concurrent procedures group than in the staged procedures (2.35/3.1.hours; 3.05/3.30.hours and 2.5/6.5 days, respectively). The average hospital bill for the concurrent procedures was also lower than for the staged procedures. Hence, in patients requiring multiple ENT surgical procedures for definitive treatment, concurrent procedures are more cost-effective than staged procedures and should be considered the treatment of choice in a tertiary care centre.

scholarly journals A STUDY OF HISTOCYTOLOGICAL FINDINGS OF LUNG LESIONS IN IMAGE GUIDED FNAC AND BIOPSY IN TERTIARY CARE CENTRE

2020 ◽  
pp. 1-3
Author(s):  
Renuka Gahine ◽  
Shashikala Kosam ◽  
Vivek Patre ◽  
Kiranlata Bhagat
Keyword(s):  
Cell Carcinoma ◽  
Predictive Value ◽  
Tertiary Care ◽  
Cost Effective ◽  
Diagnostic Procedures ◽  
Lung Lesion ◽  
Tertiary Care Centre ◽  
Predisposing Factor ◽  
Lung Lesions ◽  
Tertiary Referral Center

Aims and Objectives: To study the cytological and histological findings of lung masses and correlate findings with clinical and radiological findings. Material and methods: The study was an observational study, comprised of two years of prospective from December 2017 to September 2019 and five years of retrospective study between October 2012 to November 2017, conducted in Histopathology & Cytology laboratory, Department of Pathology, Pt. J.N.M. Medical College & Dr. B.R.A.M. Hospital, Raipur, (C.G.), a tertiary referral center. Result: Total 104 cases were studied . Out of 104 lung lesions 74 (71.2%) were males and 30 (28.8%) were females with M:F of 2.46:1. Majority of lung lesions were seen in the age group of 61-70 years i.e. 35 (33.66%) and 51-60 years i.e. 30 (28.85%) followed by 41-50 years 17 (16.35%). Mean age of the patients in our study was 56.4 years. Smoking was the most common predisposing factor for lung carcinoma observed in 58 (55.77%) cases followed by tobacco chewing. Clinically the most common complaint was cough in 65 (62.5%) cases, followed by weight loss. 10 cases were diagnosed as benign and 94 cases as malignant. Among benign lesions most common lung lesions were non-specific inflammatory lesions reported in 6 (5.77%) cases followed by granulomatous lesion in 3 (2.89%), hydatid cyst in 2 (1.93%) and aspergilloma in 1 (0.97%) case. Adenocarcinoma was the most common malignant lung lesion found in 52 (50%) cases followed by Squamous cell carcinoma 20 (24%), Small cell carcinoma 12 (13.04%) and Poorly differentiated carcinoma 6 (5.77%) cases. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of our study was 97.83%, 66.67%, 95.74%, 80.0% and 94.23% respectively. Conclusion: Guided FNAC and biopsy are safe, simple, less invasive, cost effective, well accepted and accurate diagnostic procedures with minimal complications and low morbidity rates.

scholarly journals A study to assess vaccine wastage in an immunization clinic of tertiary care centre, Gwalior, Madhya Pradesh, India

2017 ◽  
Vol 5 (6) ◽  
pp. 2472 ◽  
Author(s):  
Ranjana Tiwari ◽  
Shatkratu Dwivedi ◽  
Piyush Swami ◽  
Rakesh Mahore ◽  
Sakshi Tiwari
Keyword(s):  
Hepatitis B ◽  
Tertiary Care ◽  
Cost Effective ◽  
Economic Benefits ◽  
Madhya Pradesh ◽  
Positive Health ◽  
Tertiary Care Centre ◽  
Tertiary Center ◽  
Wastage Rate ◽  
Key Factor

Background: Vaccines are one of the most successful and cost-effective health intervention. It becomes imperative that use of vaccine was done through a proper framework of practical decision-making that confers positive health and economic benefits to the society of which Vaccine Wastage was a key factor. The aim of the study is to assess “Vaccine Wastage Rate” and “Wastage Factor” of different vaccines given to beneficiaries in Immunization Clinic and based on the above data, recommend measures to reduce it in the Immunization clinic  Methods: The present study was a Record Based Retrospective study carried out in Immunization Clinic in Madhav Dispensary of tertiary center at Gajra Raja Medical College, Gwalior, Madhya Pradesh, India. The data was collected from 1 April 2015 - 31 March 2016.Results: Immunization Sessions were conducted in Immunization clinic during reference period and 7 vaccines BCG, OPV, DPT, Hepatitis B, pentavalent, measles and TT were given. Among individual vaccines, wastage rate and wastage factor in BCG (20.71 and 1.26), OPV (14.65 and 1.17), DPT (15.6 and 1.18), Hepatitis B (10.56 and 1.12), Pentavalent (5.2 and 1.05), Measles (21.68 and 1.28), TT (7.09 and 1.08), and IPV (10.49 and 1.12) was respectively.Conclusions: Vaccine wastage could be expected in all programmes and there should be an acceptable limit of wastage. Innovative techniques to be developed not only to reduce wastage but also the operational cost for convenience of children who were to be vaccinated and parents who bring their children for vaccination without compromising coverage. 

scholarly journals Endobronchial valve vs coil for lung volume reduction in emphysema: results from a tertiary care centre in Turkey

2020 ◽  
Vol 40 (6) ◽  
pp. 469-476
Author(s):  
Ahmet Dumanli ◽  
Bayram Metin ◽  
Ersin Gunay
Keyword(s):  
Tertiary Care ◽  
Vital Signs ◽  
Blood Gases ◽  
Care Centre ◽  
Arterial Blood Gases ◽  
Lung Volume Reduction ◽  
Tertiary Care Centre ◽  
Walking Test ◽  
Arterial Blood ◽  
Endobronchial Valve

ABSTRACT BACKGROUND: Bronchoscopic lung volume reduction (BLVR) by either the endobronchial valve (EBV) or coil (EBC) procedure is recommended for severe emphysematous patients. BLVR applications generally help healthy lung areas ventilate more comfortably by reducing the hyperinflation and improving the contraction capacity of diaphragm. OBJECTIVES: Compare our experience with valve and coil BLVR devices. DESIGN: Retrospective. SETTING: Single tertiary care centre. PATIENTS AND METHODS: Demographic data, vital signs, pulmonary function tests (PFTs), the six-minute walking test (6MWT), vital signs, arterial blood gases and complications were recorded. MAIN OUTCOME MEASURES: Change in PFTs and completion of the 6MWT. SAMPLE SIZE: 60 Turkish men with a diagnosis of chronic pulmonary lung disease. RESULTS: Clinical and demographic characteristics were similar in patients who underwent EBV and EBC. Thirty (96.8%) EBV patients and 27 (93.1%) of the EBC patients were able to properly complete the PFT before the procedures, but all complied after the procedures. Significant improvement in PFTs were achieved after the procedure and there were no statistically significant differences in post-procedure performance. For the 6MWT, the completion rate improved from 15 (48.4%) to 19 (61.3%) patients in the EBV patients ( P =.125) and from 19 (65.5%) to 21 (72.4%) patients in the EBC patients ( P =.500). There was no significant difference in completion rates for the walking test for either group (median 32 meters in EBV patients and 37 meters in EBC patients; P =.652). Vital signs and arterial blood gases were similar in the two groups. The rates of complications were similar in both groups. CONCLUSION: Endobronchial valves and coils are safe and effective methods for BLVR for patients with severe emphysema. LIMITATIONS: Relatively small sample, retrospective design, single-centre retrospective study. CONFLICT OF INTEREST: None.

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.

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