scholarly journals Concurrent administration of oxytocin with Foley catheter versus misoprostol for induction of labor: A systematic review

2020 ◽  
Author(s):  
Mohamed A. Abdel Aziz ◽  
Shayeste Jahanfar ◽  
Parvin Abedi ◽  
Shahla Faal

Abstract Objectives: Around one- third of pregnancies require labor induction due to issues such as post-term pregnancy, stillbirth, and medical complications. This systematic review aimed to evaluate the effect of concurrent administration of Foley catheter plus oxytocin vs. misoprostol on labor induction. Methods: The search was conducted in April 2019. The following databases were searched: PubMed, SCOPUS, Cochrane Central Register of controlled trials and Web of Science. Primary outcomes included mode of delivery and cesarean section rate. Secondary outcomes were the mean time of induction to delivery and delivery in less than 12 hours from induction. Data were analyzed using RevMan. For binary outcomes, the odds ratio with 95% confidence intervals (CI), and for continuous outcomes, the mean difference (MD) with 95% CI was measured. Results: Four studies were included in this review. The cesarean section and vaginal delivery rate in Foley + oxytocin was not significantly different from misoprostol (OR = 0.95; 95 % CI: 0.70, 1.30) and (OR = 0.92; 95 % CI: 0.66, 1.29) respectively. Foley + oxytocin decreased the mean time of induction to delivery compared to misoprostol (MD = 0.60; 95 % CI: 0.03, 1.16), and increased delivery in less than 12 hours from induction (OR = 2.08; 95 % CI: 1.43, 3.02). Conclusion: Although the rate of cesarean and vaginal delivery was not significant in two groups of Foley catheter + oxytocin and misoprostol, the mean time of induction to delivery reduced and delivery in less than 12 hours from induction increased in the Foley +oxytocin.

2020 ◽  
Author(s):  
Mohamed A. Abdel Aziz ◽  
Shayeste Jahanfar ◽  
Parvin Abedi ◽  
Shahla Faal

Abstract Background: Around one- third of pregnancies require labor induction due to several reasons such as post-term pregnancy, stillbirth, and medical complications. This systematic review aimed to evaluate the effect of concurrent administration of Foley catheter plus oxytocin versus Misoprostol on labor induction.Methods: The search was conducted in April 2019 and updated in September 2020. The following databases were searched: PubMed, SCOPUS, Cochrane Central Register of controlled trials, and Web of Science. Primary outcome included cesarean section rate. Secondary outcomes were the mean duration of induction to delivery and delivery in less than 12 hours from induction. Data were analyzed using RevMan. For binary outcomes, the odds ratio with 95% confidence intervals (CI), and for continuous outcomes, the mean difference (MD) with 95% CI was measured.Results: Four studies were included in this review. The cesarean section rate in Foley plus oxytocin was not significantly different from vaginal Misoprostol (OR = 0.95; 95 % CI: 0.70, 1.30) and (OR = 0.92; 95 % CI: 0.66, 1.29) respectively. Foley plus oxytocin decreased the mean duration of induction to delivery compared to vaginal Misoprostol in nuligravida (MD = -6.74; 95% CI -9.20, -4.28), and increased delivery in less than 12 hours from induction (OR = 2.08; 95 % CI: 1.43, 3.02).Conclusion: Although the rate of cesarean and vaginal delivery was not different in two groups of Foley catheter plus oxytocin and vaginal Misoprostol, the mean time of induction to delivery reduced and delivery in less than 12 hours from induction increased in the Foley plus oxytocin.


Author(s):  
Keerthi Somu ◽  
Sujatha B. S. ◽  
Shripad Hebbar ◽  
Shyamala G. ◽  
Muralidhar V. Pai

Background: The attitude of the fetal head during labour significantly influences the progress and outcome of delivery and is mainly diagnosed by vaginal examination during labour. The aim of the study was to quantify the extent of deflexion of the fetal head by measuring the fetal occiput spine angle (OSA) through transabdominal ultrasonography in the first stage of labour and to determine whether the fetal OSA can predict the mode of delivery.Methods: We conducted a prospective observational study on 145 nulliparous uncomplicated singleton pregnant women without occiput-posterior position of the fetus during active labour. The OSA was measured as the angle between the two tangential lines to the occipital bone and the vertebral body of the first cervical spine, during active labour and monitored until delivery. Intra- and interobserver reproducibility of the OSA measurement and the correlation between the OSA and mode of delivery were also evaluated.Results: For the study population, the mean value of the OSA measured in the active phase of the first stage was 124.2±11.5⁰. The OSA measurement showed excellent intraobserver agreement (r = 0.82; 95% confidence interval [95% CI] 0.70-0.80) and fair-to-good interobserver agreement (r = 0.62; 95% CI 0.51-0.71).  The mean OSA was significantly less for the group of patients who required conversion to cesarean section due to labour arrest (n=32) as compared to those who had vaginal delivery (n=113) (116.25±9.2⁰ versus 126.53±11.1⁰, P<0.01). An OSA of ≥121° was associated with vaginal delivery in 80.5% (91/113) of women, whereas 87.5% (28/32) of the women who delivered by cesarean section had an OSA <121⁰.Conclusions: Measurement of the OSA, by sonography is feasible, reproducible and an objective tool to assess the degree of fetal head deflexion during labour and to predict the mode of delivery.


2013 ◽  
Vol 26 (2) ◽  
pp. 81-85
Author(s):  
Nabila Aminu Buhari ◽  
Sumayya Lugman Ahmed ◽  
Nastaran Redha Sohrabi ◽  
Hidayat Yetunde Ogunsola ◽  
Riwana B Shaikh ◽  
...  

Objectives: To study various methods of induction of labor and their effect on mode of delivery  and fetal outcome.Methods: 104 pregnant women induced in Gulf Medical College hospital from August to   November 2009 were included. Mothers were observed from the start of their induction and  followed up till they were discharged. The methods of induction compared were the use of prostaglandin, oxytocin, prostaglandin and oxytocin combined and artificial rupture of membranes.Results: Out of 104 pregnant women, 86 (89%) had normal vaginal delivery. Of these, 36 (41.9%) were induced with combination of prostaglandin and oxytocin, 32 (37.2%) with prostaglandin, 14 (16.2%) with oxytocin, and 4 (4.6%) with artificial rupture of membranes. 13 (12.5%) mothers delivered through caesarean section of these, 7 (53.8%) mothers were induced with prostaglandin, 3 (23%) with prostaglandin and oxytocin, 2 (15.3%) with oxytocin alone, and 1 (7.7%) with artificial rupture of membranes. Induction of labor with combination of prostaglandin and oxytocin was found to be the most effective method. Duration of labor between primigravidas and multigravidas were significantly different with primigravidas having longer duration of labor with mean time of 12.47 hours while multigravidas had 9.16 hours.Conclusion: Induction of labor with combination of prostaglandin and oxytocin was found to be the most effective method in this study with very good progressing to normal vaginal delivery. Further research is needed on a larger scale to compare other methods of labor induction on parturient to be able to recommend the most effective method of labor induction. DOI: http://dx.doi.org/10.3329/bjog.v26i2.13785 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 81-85  


2020 ◽  
Vol 16 ◽  
Author(s):  
Mounica Lella ◽  
Jyothi Shetty ◽  
Keerti Kyalakond ◽  
Murlidhar V Pai

Objective: To study the outcomes of membrane sweep done during induction of labor with sublingual misoprostol at term pregnancy such as the mode of delivery and the induction delivery interval. Methods: This prospective descriptive study was conducted in 305 term women (237 primigravida and 68 multigravida) who received sublingual misoprostol followed by membrane sweep (single or double sweep based on the progress of labor). Main outcome measures included mode of delivery, induction to delivery interval, duration of labor, neonatal outcomes and maternal complications. Results: Among 237 primigravida, 108 (45.5%) women delivered after a single sweep and 129 (54.4%) women needed a second sweep. Among 68 multigravida, 47 (69.1%) delivered after a single sweep and only 21 (30.8%) required a second sweep. Maximum number (75.5%) of primigravida had pre-induction Bishop score of 2 while maximum number (67.6%) of multigravida had pre-induction Bishop score of 3. Vaginal deliveries (including instrumental delivery) were more in both primigravida (55.6%) and multigravida (88.2%) who received membrane sweep in conjunction with induction of labor. The mean time from the first dose of sublingual misoprostol to the onset of contraction was 6.9 hours in primigravida and 4.2 hours in multigravida while the meantime from the onset of contractions till vaginal delivery (duration of labor) was 11.2 hours in primigravida and 5.8 hours in multigravida. The mean interval from induction to the vaginal delivery was 18.8 hours in primigravida and 14.4 hours in multigravida. Conclusion: Sublingual misoprostol, along with membrane sweep at the initiation of labor induction is an effective intervention despite its association with increased rate of cesarian section among primigravida as compared to the literature.


2020 ◽  
Author(s):  
Diana Raj ◽  
Halimatus Sakdiah Minhat ◽  
Nor Afiah Mohd. Zulkefli ◽  
Norliza Ahmad

BACKGROUND The increasing screen time exposure among young children in general and the reported negative consequences associated with excessive ST, calls for focused strategies to reduce ST, especially among young children. OBJECTIVE This systematic review aimed to identify effective parental intervention strategies to reduce ST among preschool children. METHODS A total of five databases, namely Cochrane Central Register of Controlled Trials, CINAHL, Medline Complete, PubMed, and Scopus, were searched for randomised controlled trials that involved intervention strategies in ST reduction among preschool children. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were used. RESULTS A total of nine studies were assessed. The results showed that besides providing knowledge and awareness regarding ST, having restrictive practices, offering alternative activities to parents, and removal of screen from child’s bedroom were the most common strategies used by studies that reported successful intervention. Intervention duration of between six to eight weeks was sufficient to produce ST reduction. Face-to-face method was the commonest mode of delivery. Theoretical constructs that aimed at increasing parental self-efficacy, listing outcome expectations, and offering reinforcement of strategies that targeted both the parents and home environment were beneficial in reducing ST. CONCLUSIONS By offering appropriate strategies to parents, a reduction in the amount of ST was observed among the children. Future intervention studies could benefit in exploring culturally adapted strategies, especially in developing countries. Trials of higher quality would also facilitate the drawing of conclusions in future research. CLINICALTRIAL PROSPERO No: CRD42020199398


2018 ◽  
Vol 46 (3) ◽  
pp. 309-316 ◽  
Author(s):  
Moritz Döbert ◽  
Aleke Brandstetter ◽  
Wolfgang Henrich ◽  
Tamina Rawnaq ◽  
Hendrik Hasselbeck ◽  
...  

AbstractAim:To compare the efficacy and safety of the misoprostol vaginal insert (MVI) with an off-label use of oral misoprostol (OM).Methods:Pair-matched case-control study comparing the induction of labor with a retrievable MVI to OM. The primary outcomes were the time from induction to delivery and the cesarean section rate. Secondary outcomes included uterine tachysystole, tocolysis, fetal scalp blood testing, meconium-stained amniotic fluid, umbilical arterial pH, and Apgar score.Results:One hundred and thirty eight women ≥37/0 weeks pregnant undergoing labor induction with misoprostol were included. The mean time from application to delivery was significantly shorter and the caesarean section rate significantly higher in the MVI group (P<0.01) with an odds ratio of 2.75 (95% CI: 1.21–6.25) in favor of vaginal delivery in the OM group. The mean 5-min Apgar scores and arterial cord pH values were significantly lower in the MVI group. An arterial pH value of 7.10–7.19 was found in 26.1% and 15.9%, and a value <7.10 was found in 4.3% and 0% of MVI and OM cases, respectively.Conclusion:The MVI compared with OM significantly shortened the time from application to delivery at the expense of a higher cesarean section rate and negative effects on neonatal outcomes.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Haonan Tian ◽  
Congman Xie ◽  
Min Lin ◽  
Hongmei Yang ◽  
Aishu Ren

Abstract Background Temporary anchorage devices have been used for decades in orthodontic practice for many applications. The aim of this systematic review was to assess the effectiveness of orthodontic temporary anchorage devices in canine retraction during the two-step technique. Methods A search was systematically performed for articles published prior to June 30, 2019 in five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus). The risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials (CCTs). The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean differences and 95% confidence intervals were analyzed for continuous data. A meta-analysis with a random-effects model for comparable outcomes was carried out. Results Three RCTs and five CCTs were finally included. Meta-analysis showed a significant increase not only in anchorage preservation in the implant anchorage group in both the maxilla (1.56 mm, 95% CI: 1.14 to 1.98, P < 0.00001) and the mandible (1.62 mm, 95% CI: 1.24 to 2.01, P < 0.00001) but also in canine retraction in the implant anchorage group in both the maxilla (0.43 mm, 95% CI: 0.16 to 0.69, P = 0.001) and the mandible (0.26 mm, 95% CI: 0.02 to 0.49, P = 0.03). Conclusions There is very low-quality evidence showing that implant anchorage is more efficient than conventional anchorage during canine retraction. Additional high-quality studies are needed.


2021 ◽  
Author(s):  
Nobuhiro Suzumori ◽  
Takeshi Ebara ◽  
Hazuki Tamada ◽  
Taro Matsuki ◽  
Hirotaka Sato ◽  
...  

Abstract Background Postpartum depression is one of the most commonly experienced psychological disorders for women after childbirth, usually occurring within one year. This study aimed to clarify whether women with painless delivery, including epidural analgesia, spinal-epidural analgesia, and paracervical block, had a decreased risk of postpartum depression after giving birth in Japan. Methods The Japan Environment and Children’s Study (JECS) was a prospective cohort study that enrolled registered fetal records (n = 104,065) in 15 regions nationwide in Japan. Binomial logistic regression analyses were performed to calculate the adjusted odd ratios (aORs) for the association between mode of delivery with or without analgesia and postpartum depression at one-, six- and twelve-months after childbirth. Results At six months after childbirth, painless vaginal delivery was associated with a higher risk of postpartum depression (aOR: 1.218, 95% confidence interval: 1.067–1.391), compared with vaginal delivery without analgesia or cesarean section. Nevertheless, the risk disappeared one year after delivery. Among the pregnant women who requested painless delivery, 5.1% had a positive Kessler-6 scale (K6) score for depression before the first trimester (p < 0.0001), which was significantly higher than the proportions in the vaginal delivery without analgesia (3.5%) and cesarean delivery (3.5%) groups. Conclusions Our data suggested that the risk of postpartum depression at six months after childbirth tended to be increased after painless vaginal delivery, compared with vaginal delivery without analgesia or cesarean section. Requests for painless delivery continue to be relatively uncommon in Japan, and women who make such requests might be more likely to experience postpartum depressive symptoms because of underlying personality characteristics, including a tendency to worry.


2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Katherine S. Bright ◽  
Elyse M. Charrois ◽  
Muhammad Kashif Mughal ◽  
Abdul Wajid ◽  
Deborah McNeil ◽  
...  

Abstract Background Interpersonal psychotherapy (IPT) is an intervention that has established efficacy in the prevention and treatment of depressive disorders. Previous systematic reviews have not evaluated the effectiveness of IPT on symptoms of stress, anxiety, depression, quality of life, relationship satisfaction/quality, social supports, and an improved psychological sense of well-being. There is limited data regarding factors that moderate and mediate the effectiveness of IPT including the timing of the intervention or the mode of delivery of IPT intervention. The objective of this systematic review and meta-analysis is to evaluate the effectiveness, feasibility, and acceptability of IPT interventions to treat perinatal psychological distress and to summarize the evidence on predictors, mediators, and moderators of IPT. Methods We will include peer-reviewed studies that recruited perinatal women. The search strategy will involve the following databases: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Cochrane Central Register of Controlled Trials (Ovid), CINAHL with Full Text (EBSCO), Social Work Abstracts (EBSCO), SocINDEX with Full Text (EBSCO), Academic Search Complete (EBSCO), Family & Society Studies Worldwide (EBSCO), Family Studies Abstracts (EBSCO), and Scopus. Study inclusion criteria include (1) randomized controlled trials, quasi-experimental studies, and pre-post studies that evaluated the effectiveness of IPT; (2) qualitative studies that evaluated feasibility and acceptability of IPT; (3) study sample included and analyzed perinatal women; and (4) publication language was English. Using pilot-tested screening and data extraction forms, two reviewers will independently review studies in three steps: (1) abstract/title screening, (2) full-text screening of potentially accepted studies, and (3) data extraction of accepted studies. Disagreements will be resolved by a third reviewer. Studies will be aggregated for meta-synthesis and meta-analysis should the data allow for this. Two independent reviewers will grade methodological quality. Discussion Findings from this review will inform future development and implementation of IPT intervention research for perinatal women. Identifying key factors of successful IPT interventions will inform intervention design and adaptation of IPT interventions to increase the likelihood that perinatal women will engage in and benefit from IPT interventions. This review will also identify key considerations for increasing the effectiveness of IPT interventions during the perinatal period. Systematic review registration PROSPERO CRD42019114292


Medicina ◽  
2020 ◽  
Vol 56 (10) ◽  
pp. 554
Author(s):  
Barbora Blazkova ◽  
Anna Pastorkova ◽  
Ivo Solansky ◽  
Milos Veleminsky ◽  
Milos Veleminsky ◽  
...  

Background and objectives: The impact of cesarean and vaginal delivery on cognitive development was analyzed in 5 year old children. Materials and Methods: Two cohorts of 5 year old children born in the years 2013 and 2014 in Karvina (Northern Moravia) and Ceske Budejovice (Southern Bohemia) were studied for their cognitive development related to vaginal (n = 117) and cesarean types of delivery (n = 51). The Bender Visual Motor Gestalt Test (BG test) and the Raven Colored Progressive Matrices (RCPM test) were used as psychological tests. Results: In the comparison of vaginal delivery vs. cesarean section, the children delivered by cesarean section scored lower and, therefore, achieved poorer performance in cognitive tests compared to those born by vaginal delivery, as shown in the RCPM (p < 0.001) and in the BG test (p < 0.001). When mothers’ education level was considered, the children whose mothers achieved a university degree scored higher in both the RCPM test (p < 0.001) and the BG test (p < 0.01) compared to the children of mothers with lower secondary education. When comparing mothers with a university degree to those with higher secondary education, there was a significant correlation between level of education and score achieved in the RCPM test (p < 0.001), but not in the BG test. Conclusions: According to our findings, the mode of delivery seems to have a significant influence on performance in psychological cognitive tests in 5 year old children in favor of those who were born by vaginal delivery. Since cesarean-born children scored notably below vaginally born children, it appears possible that cesarean delivery may have a convincingly adverse effect on children’s further cognitive development.


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