scholarly journals A randomized prospective comparative study to evaluate the efficacy of prostaglandin E2 (Dinoprostone) controlled release vaginal insert versus sublingual prostaglandin E1(Misoprostol) in induction of labor in term gestation

2021 ◽  
Vol 8 (4) ◽  
pp. 457-462
Author(s):  
Rakhee Sahu ◽  
Kirti Janjewal
Keyword(s):  
Comparative Study ◽  
Pregnant Women ◽  
Fetal Outcome ◽  
Induction Of Labor ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Significant Difference ◽  
Misoprostol Group ◽  
Prospective Comparative Study ◽  
The Mean

In modern obstetrics, one of the common challenges is induction of labour (IOL). WHO Global Survey reported that IOL accounted for 9.6% of all deliveries. Prostaglandins have evolved and frequently used pharmacologic agents for IOL, owing to their dual action of cervical ripening and uterine contraction inducing effect. : 1. To compare the efficacy and induction to delivery interval (IDI) of PGE2 vaginal insert and Sublingual PGE1 in induction of labor in term pregnant women; 2. To study the maternal and fetal outcome in both groups.: This a randomized, prospective, comparative study of 100 term pregnant women for induction of labour. Group 1-(50 women) PGE2-10mg vaginal insert and group 2-(50 women) PE1 Sublingual tablets – maximum 200 mcg in 24 hrs, at Dr LH Hiranandani Hospital, Mumbai, India.: In my study the mean induction to delivery interval in Dinoprostone group was 17.47 hours and 23.44 hours in Misoprostol group. So the mean IDI was shorter in Dinoprostone insert group than Misoprostol group by about 6 hours. There was no significant difference noted in terms of overall incidence of caesarean deliveries among the groups. Our study concluded that Dinoprostone 10mg vaginal insert was more efficacious than sublingual Misoprostol in reducing induction to delivery interval without maternal and fetal complications.Our study suggests that the Dinoprostone vaginal insert can be used as both inducing as well as augmentating agent in labour. Dinoprostone vaginal insert maybe more effective in reducing the incidence of caesarean sections.

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).

A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (41) ◽  
pp. 3559-3566
Author(s):  
Abdul Salam R. T. ◽  
Shahul Hameed A. ◽  
Meera Rajan
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Tertiary Care ◽  
Operation Time ◽  
Care Hospital ◽  
Adenoid Tissue ◽  
Significant Difference ◽  
Tube Function ◽  
Prospective Comparative Study ◽  
The Mean

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

scholarly journals A comparative study of intra-cervical foley’s catheter and PGE2 gel for induction of labour at term

2019 ◽  
Vol 8 (9) ◽  
pp. 3689
Author(s):  
Anjali R. Kanada ◽  
Mahima Jain
Keyword(s):  
Side Effects ◽  
Caesarean Section ◽  
Comparative Study ◽  
Foley Catheter ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Mechanical Methods ◽  
Significant Difference ◽  
Foley’S Catheter

Background: In cervical ripening, before induction of labour, is needed to increase the success of labour induction, to reduce complications and to diminish the rate of caesarean section and duration of labour. Pharmacological preparations are in widespread use for cervical ripening but are not free from side-effects and complications. Mechanical methods, i.e. the use of Foley’s catheter balloon, though effective have not gained much popularity because of the fear of infection. Therefore, the study has been conducted to prove the efficacy and safety of extra amniotic Foley catheter balloon and to compare it with intra-cervical prostaglandin E2 (PGE2) gel. The objective of the study was to the success of induction of labor depends on the cervical status at the time of induction. For effective cervical ripening both Foley's catheter and PGE2 gel are used. The aim of this study was to compare the efficacy of intra cervical Foley's catheter and intra cervical PGE2 gel in cervical ripening for the successful induction of labor.Methods: A randomized, comparative study was conducted in the department of obstetrics and gynaecology, Civil hospital, B.J. Medical College Ahmedabad, during a period of 8 month from September 2018 to April 2019. 100 patients at term with a Bishop's score ≤5 with various indications for induction were randomly allocated to group F (intra-cervical Foley’s catheter) and group P (PGE2 gel) with 50 women included in each group.Results: The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed significant change in the Bishop's score, 5.10±1.55 and 5.14±1.60 for Foley's catheter and PGE2 gel, respectively, p <0.001. However there was no significant difference between the two groups. There was no significant difference in the side effects and caesarean section rate in both groups. The induction to delivery interval was 16.01±5.50 hours in group F and 16.85 ± 3.81 hours in group P (p=0.073). Apgar scores, birth weights and NICU admissions showed no significant difference between the two groups.Conclusions: The study shows that both Foley's catheter and PGE2 gel are equally effective in pre induction cervical ripening.

scholarly journals A 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.

Prospective comparative study of endoscopic ultrasonography-guided fine-needle biopsy and unroofing biopsy.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 38-38 ◽  
Author(s):  
Sung Kwan Shin ◽  
Jun Chul Park ◽  
Eun Hye Kim ◽  
Sang Kil Lee ◽  
Yong Chan Lee
Keyword(s):  
Comparative Study ◽  
Endoscopic Ultrasonography ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Fine Needle Biopsy ◽  
Histological Diagnosis ◽  
Fine Needle ◽  
Significant Difference ◽  
Prospective Comparative Study ◽  
The Mean

38 Background: Adequate tissue acquisition is important in making treatment decisions for patients with upper gastrointestinal subepithelial tumors (SETs). This study aimed to compare the outcomes of endoscopic ultrasonography-guided fine-needle biopsy (EUS-FNB) with those of the unroofing biopsy technique. Methods: This study was a single-center, prospective comparative study conducted at Severance Hospital, Yonsei University College of Medicine. A total of 39 patients with SETs ≥15 mm were enrolled between January 2016 and August 2017. Results: Of the 39 patients, 28 underwent biopsy with both techniques (4 underwent only unroofing and 7 underwent only EUS-FNB). The mean tumor size was 21.0 mm (median, 19.0 mm; 15.0–45.0 mm). Histological diagnosis was made with EUS-FNB in 64.3% and with unroofing biopsy in 78.6% (p = 0.344), and immunohistochemical diagnosis was made with EUS-FNB in 46.4% and unroofing biopsy in 67.9% (p = 0.180). In the subgroup analysis (28 patients), there was no significant difference in diagnostic yield between the 2 methods. The mean procedural time with EUS-FNB was shorter than that with unroofing biopsy (p < 0.001). The larger SET (≥ 20 mm) (p = 0.035) and satisfaction of procedure (p = 0.019) were positively associated with successful histological diagnosis by EUS-FNB. No complications were reported with both methods. Conclusions: There was no significant difference in the histological diagnostic yield for SETs between the EUS-FNB and unroofing biopsy techniques. Further study is needed to confirm the efficacy of EUS-FNB and unroofing biopsy in a larger study population. Clinical trial information: NCT02646241.

scholarly journals Comparison between Sublingual and Vaginal Misoprostol for Induction of Labour in Primigravida

2018 ◽  
Vol 13 (3) ◽  
pp. 51-55
Author(s):  
Sailaja Ghimire ◽  
Deepanjali Sharma ◽  
Samjhana Dhakal ◽  
Gehanath Baral
Keyword(s):  
Fetal Distress ◽  
Fetal Outcome ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
P Value ◽  
Time Interval ◽  
Vaginal Route ◽  
Sublingual Misoprostol ◽  
The Mean ◽  
Vaginal Misoprostol

Aims: To compare the outcome and side effects of administration of sublingual misoprostol with vaginal misoprostol for induction of labour and cervical ripening. Methods: It was a hospital based comparative study which was carried out in 120 patients in each group of sublingual and vaginal route of misoprostol induction from August 2016 to February 2017 at Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu. Patients with Bishops score <6 were subjected for Misoprostol 25 μg (for maximum 2 doses) 6 hours apart. Results were analyzed using SPSS 21 taking p-value <0.05 as statistically significant. Results: The mean change in Bishops score after 6 hours of misoprostol was statistically signifi cantly (p=0.001) in sublingual group in comparison to vaginal group. The diff erence in augmentation rate was not statistically signifi cant (p= 0.811). The mean time interval from drug administration to delivery was almost similar in both groups. The indications for cesarean section were similar in both the groups, the most common being fetal distress, (67.33% in sublingual and 58.065% in vaginal group). In terms of maternal and neonatal outcome there was no difference. Conclusions: Sublingual route results in significant changes of Bishop’s score as compared to vaginal route. It was also significantly better in terms of fetal outcome. However, both routes appeared similar in terms of maternal outcome.

scholarly journals A study of vaginal misoprostol tablet versus intra cervical dinoprostone gel for the induction of labour

2017 ◽  
Vol 6 (4) ◽  
pp. 1404
Author(s):  
Chandni N. Badlani ◽  
Shraddha S. Shastri ◽  
Neelesh S. Risbud
Keyword(s):  
Cost Effective ◽  
Induction Of Labor ◽  
Significant Difference ◽  
Misoprostol Group ◽  
Group A ◽  
The Mean ◽  
Nicu Admission ◽  
Vaginal Misoprostol ◽  
Group B ◽  
To Receive

Background: This was a comparative study conducted to compare the effectiveness of 25 microgram of intravaginal misoprostol with intracervical dinoprostone gel in terms of efficacy of drug, feto-maternal outcome, side effects and complications of drugs.Methods: 400 nulliparas at term, admitted for induction of labor were included in this study. They were randomly selected to receive either intravaginal misoprostol or intracervical dinoprostone gel. Group A (200 women) recieved tablet misoprostol 25 micrograms vaginally 4 hrly to a maximum of 3 doses and Group B (200 women) received dinoprostone gel 0.5mg intracervically 6 hrly to a maximum of 3 doses. Comparison was done in terms of Induction to delivery interval, need for augmentation, LSCS and instrumentation rate, need for NICU admissions and cost effectiveness.Results: The mean induction to delivery interval was less in the misoprostol group than dinoprostone group (12.5 hrs vs. 20 hrs). 78% patients delivered in the first 24 hrs in misoprostol group compared to 52 % patients in dinoprostone group. Group A had a higher success rate (81% vs.76%) and also required less augmentation of labor ( 30% vs. 60%) compared to group B. Need for LSCS was also lower in misoprostol group (11% vs. 16%). Need for instrumentation and incidence of NICU admission was similar in both groups. Misoprostol was more cost effective compared to dinoprostone.Conclusions: The misoprostol group had a shorter induction to delivery interval, more number of deliveries in the first 24 hrs of induction and a reduced need of augmentation of labor with oxytocin. There was no significant difference in the rate of caesarean section, hyper-stimulation syndrome, neonatal and maternal morbidity between the two groups. Thus, misoprosol appears to be safer, cheaper and more efficacious alternative for induction of labor especially for non-fetal indications as compared to dinoprostone gel.

scholarly journals Cervical Ripening: Comparative Study between Intracervical Balooning by Foley’s Catheter and Intravaginal Misoprostol Tablet

1970 ◽  
Vol 27 (1) ◽  
pp. 5-12
Author(s):  
Jannatul A Ferdous ◽  
Nurun Nahar Khanam ◽  
Most. Rashida Begum ◽  
Sayeba Akhter
Keyword(s):  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
College Hospital ◽  
Socioeconomic Condition ◽  
Medical College ◽  
Catheter Group ◽  
Misoprostol Group ◽  
Foley’S Catheter

This study was designed to compare the effectiveness of misoprostol and Foley's catheter on cervical ripening. A randomized clinical trial was carried out at Dhaka Medical College Hospital during the period from March 2002 to November 2002. Ninety patients, who were chosen for induction, were selected for this study, 45 patients were randomly selected for Foley's catheter group and 45 patients for misoprostol group by using lottery. The baseline characteristics like age, parity, socioeconomic condition, gestational age; Bishop's score and indication of induction of labor were almost same in both groups. Mean duration of onset of labour was 13.60±5.0 and 15.26±3.58 hours, induction-full dilatation was 18.83±2.94 and 20.03±2.46 hours and induction-delivery interval was 20.04±2.82 and 21.18±2.32 hours in the misoprostol and Foley's catheter groups respectively. The differences were not significant. Mode of delivery and fetal outcome were also same in both group. Complications like vomiting and hyperstimulation appeared in few cases in misoprostol group but not significant. From this study, it was found that the safety and efficacy of Foley's catheter is comparable to misoprostol. In addition, Foley's catheter is free from some side effects of misoprostol, like vomiting and hyperstimulation. Therefore, Foley's catheter can be used for cervical ripening. Key words: Induction of labor, Foley's catheter, misoprostol DOI: 10.3329/jbcps.v27i1.4237 J Bangladesh Coll Phys Surg 2009; 27: 5-12

scholarly journals Comparison of the safety and efficacy of intracervical Foleys catheter versus PGE2 gel for induction of labour at term

2021 ◽  
Vol 10 (5) ◽  
pp. 1842
Author(s):  
Prakruti P. Patel ◽  
Mittal V. Bhabhor ◽  
Pankti Jayswal ◽  
Saila A. Khatri ◽  
Grishma P. Brahmbhatt ◽  
...  
Keyword(s):  
Fetal Outcome ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
P Value ◽  
Chi Square ◽  
Medical College ◽  
Mechanical Methods ◽  
Significant Difference ◽  
Chi Square Test ◽  
Nicu Admission

Background: Before the induction of labour cervical ripening is needed for the success of induction to reduce the complication and diminish the rate of cesarean section and duration of labour. Various mechanical methods like Foleys catheter are effective but not much popular because of infection and pharmacological preparations which have more side effects, are used for cervical ripening. Therefore study has been conducted to compare the efficacy and safety of intra cervical Foleys catheter versus PGE2 gel for induction of labour at term. The aims and objectives of this study was to success of induction of labour depends on the cervical status at the time of induction.Methods: A prospective comparative study was conducted in the department of obstetrics and gynecology, L.G. hospital (AMCMET Medical college), Ahmedabad, during period of July 2019 to December 2019. 100 patients at term with a Bishop’s score with various indications for induction were randomly allocated to receive (50 patients) intra cervical Foleys catheter or PGE2 gel (50 patients). Post induction Bishop’s score was noted after 6 hours, 12 hours, 24 hours. Statistical methods used were Student t test and Chi square test to statistically compare the two groups. Differences with a p value of <0.005 was considered statistically significant with confidence limit of 95%.Results: The groups were comparable with respect to maternal age, gestational age, parity, indication of induction and initial bishops score. Both groups showed significant change in the Bishops score, 5.10±1.55 and 5.14±1.60 for Foleys catheter and PGE2 gel, respectively, p<0.001. Fetal outcome was noted in NICU admission and fetal death. No significant difference between two groups.Conclusions: This study shows that both Foleys catheter and PGE2 gel were equally effective in pre induction cervical ripening.

scholarly journals Mifepristone: an alternate to dinoprostone in induction of labour

2017 ◽  
Vol 6 (5) ◽  
pp. 1880 ◽  
Author(s):  
Sailatha R. ◽  
Famida A. M. ◽  
Vinoth Gnana Chellaiyan D. ◽  
Vijayalakshmi K. ◽  
Sathiya S. ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Fetal Outcome ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Group 4 ◽  
Prospective Comparative Study ◽  
Unfavorable Cervix ◽  
Failed Induction ◽  
One Year ◽  
Group 1

Background: To assess and compare the efficacy, safety and fetomaternal outcome of mifepristone versus dinoprostone in priming the cervix and in inducing labour in pregnant women at term.Methods: This is a prospective comparative study done in Chettinad health and research institute, over a period of one year from October 2015 to October 2016. 50 pregnant women (Group 1) in 3rd trimester with unfavorable cervix were given 200mcg of mifepristone orally. If labour did not start or if the Bishop score remained poor at the end of 24hrs, induction was continued with 0.5mg of dinoprostone gel at a maximum of 3 gels at 6th hourly interval. Another 50 pregnant women (Group2) in 3rd trimester underwent induction according to the routine dinoprostone gel regimen of maximum 3 gels at intervals of 6hrs.Results: Improvement in Bishop score was significant with mifepristone by the end of 24hrs.But, in comparison, there was statistically significant improvement in Bishop score in favour of dinoprostone (Mean 4.7) than mifepristone (Mean 4.0). Also, the induction delivery interval was significantly less (Mean 11.5 hrs) with dinoprostone than mifepristone (Mean 20.3 hrs). Number of cases undergoing LSCS for failed induction was less in mifepristone group (4%). The rate of vaginal delivery, Caesarean sections, instrumental delivery and overall fetal outcome was comparable in both groups.Conclusions: Mifepristone is a safe, effective and suitable alternate agent for cervical ripening and initiation of labour when given 24 h before onset of labour. 

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