scholarly journals The safest method of inducing labour with misoprostol

2021 ◽  
Vol 9 (1) ◽  
pp. 73-79
Author(s):  
L.F. Kasungu
Keyword(s):  
Previous History ◽  
Active Phase ◽  
Fetal Distress ◽  
Caesarian Section ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Intrauterine Fetal Death ◽  
Spontaneous Vaginal Delivery ◽  
Accurate Dose ◽  
Optimal Regimen

Prolong pregnancy cause is unknown; some risk factors like obesity and the previous history has been outlined. The risk for bad outcomes increases with the increase in the time of delivery. Intrauterine fetal death, meconium aspiration, fetal distress, oligohydramnios increased rate of caesarian section are among the complications. Timely delivery with accurate dose of Misoprostol can reduce the bad outcomes. Misoprostol is a prostaglandin, not expensive and easy to store but with different side effect once wrongly administered. It is not indicated for obstetrics and gynecology in some countries but currently it is widely used for induction of labour. To assess the effect of Oral miso juice and its outcomes for labour induction in postterm cases and in premature rupture of membrane (PROM) at term. Search of registered documented files of clients at Kivulini Maternity Center for the year 2020. Out of 2399 deliveries per year, 67 received oral miso juice due to postterm and PROM. 61 participants aged 17 to 34 years and 6 females were above 35 years of age. 44 (65.7%) started active phase of labour within 24 hours and delivered. 16 (23.9 %) delivered after 24 hours of oral miso juice administration. 7 (10.4%) took more than 48 hours and delivered safely. 57 (85%) of those who received oral miso juice had SVD and 10 (15%) underwent emergency caesarian section due to a complication of Misoprostol as well since the drug can course fetal distress, meconium stained and other complications. 66 (98.5%) of all deliveries had Apgar score of >7 in the 1st minute, while 1 (1.5%) had Apgar of <7. Out of all deliveries, only 1 (1.5%) underwent caesarian section reason being non reassuring fetal status (NRFS). Out of all deliveries, 14 (20%) were accompanied by perineum tear of I&II degree and in 14 (20%) cases episiotomy was applied. The weight of the babies delivered after miso juice was distributed as follows: 2.5 to 3.5 kg – 54 cases and 3.6 to 4.5kg – 13 cases. No babies were delivered with weight above 4.5 kg. Among them, 33 (49%) were male babies and 34 (51%) were female babies. Oral miso juice is effective to achieve a safe spontaneous vaginal delivery. It is more effective than other method of induction of labour especially in developing country and in facility with limited human resources. It is possible to say that oral miso juice is the optimal regimen with less risk once in a right dose.

A COMPARATIVE STUDY OF MIFEPRISTONE AND MISOPROSTOL VERSUS MISOPROSTOL ALONE IN INDUCTION OF LABOUR IN LATE INTRAUTERINE FETAL DEATH

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Shivpal Moond ◽  
K.P. Banerjee ◽  
Rakhi Arya
Keyword(s):  
Single Dose ◽  
Comparative Study ◽  
Fetal Death ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Intrauterine Fetal Death ◽  
P Value ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare efficacy, safety and tolerance of combination of Mifepristone and Misoprostol versus Misoprostol alone in induction of labour in late intrauterine fetal death (>24 weeks). Methods: This prospectively study included 160 women with late intrauterine fetal death (IUFD) after 24 weeks of gestation and divided the women randomly into two groups each containing 80 women. In Group-A : Mifepristone 200 mg single dose was given and after 24 hrs Tab Misoprostol (intravaginally) administered and repeated 4 hourly upto a maximum of 5 doses, while in Group-B : Only Tab Misoprostol administered intravaginally 4 hourly upto maximum 5 doses. Induction-delivery interval and number of doses of Misoprostol was calculated.    Results: The mean induction-delivery interval in Group-A was 13.02 ± 3.74 hours and in Group-B was 16.09 ± 2.99 hours (p-value <0.0001). Mean doses of Misoprostol required in Group-A was 3.36 ± 1.08 hours and in Group-B was 4.32 ± 0.65 hours (p-value <0.0001). Conclusion: Combination of Mifepristone and Misoprostol is more effective as comparison to Misoprostol in terms of induction-delivery interval and number of doses of misoprostol required.    Keywords: IUFD, mifepristone, misoprostol, induction of labour, induction-delivery interval.

scholarly journals A study comparing vaginal misoprostol alone with vaginal misoprostol in combination with Foley catheter for cervical ripening and labour induction

2017 ◽  
Vol 6 (2) ◽  
pp. 485 ◽  
Author(s):  
Binti R. Bhatiyani ◽  
Manisha R. Gandhewar ◽  
Swati Kapsikar ◽  
Pradip Gaikwad
Keyword(s):  
Foley Catheter ◽  
Active Phase ◽  
Fetal Distress ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Combination Group ◽  
Maternal Complications ◽  
Misoprostol Group ◽  
Vaginal Misoprostol

Background: Induction of labor is a commonly practised intervention in modern obstetrics. The objective of this study was to compare the efficacy of vaginal misoprostol alone with vaginal misoprostol in combination with Foley catheter for labour induction. It aims to assess the induction delivery interval, the outcome of labour, the incidence of instrumental delivery and Cesarean section. The neonatal outcomes and maternal complications would also be assessed.Methods: 105 women with singleton viable pregnancies of 28 weeks or more gestation with cephalic presentation, intact membranes and an unfavorable cervix (Bishops score less than 6) were randomly assigned to induction of labor using vaginal misoprostol or Foley catheter in combination with vaginal misoprostol. Women in the misoprostol only group received 25 micrograms of misoprostol per vagina every 4 hours for a maximum of six doses. Whereas women in the combination group received vaginal misoprostol and in addition Foley catheter was introduced through the cervix for 12 hours. Interruption of the trial was done in case of failure to enter the active phase of labour after 24 hours of induction, fetal distress, hyperstimulation, hypersensitivity to drugs.Results: The induction to delivery time was shorter in misoprostol group as compared to the Foley with misoprostol group by 3 hours. There was no significant change in Bishops score after induction with Foley in combination with misoprostol as compared to misoprostol alone. There was no increase in the maternal and fetal complications in the misoprostol group as compared to Foley with misoprostol.Conclusions: Misoprostol alone was more efficacious for ripening and inducing agent as compared to Foley in combination with misoprostol.

scholarly journals Profiling cervical ripening for induction of labour with Foley’s balloon catheter in Ebonyi state, Nigeria: a randomized controlled trial

2021 ◽  
Vol 10 (1) ◽  
pp. 22
Author(s):  
Nnabugwu Alfred Adiele ◽  
Christian C. Mgbafulu ◽  
Arinze Chidiebere Ikeotuonye ◽  
Christian Chidebe Anikwe ◽  
Joshua Adeniyi Adebayo ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Foley Catheter ◽  
Balloon Catheter ◽  
Active Phase ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Controlled Study ◽  
Bishop Score ◽  
Randomized Controlled

Background: The ripeness of the cervix is an important prerequisite to a successful labour induction. Use of extra-amniotic Foley catheter is a mechanical method of cervical ripening with proven efficacy. This study compared the difference in efficacy between 30 ml and 60 ml of water for inflation of Foley catheter balloon when used for cervical ripening during induction of labour.Methods: A single-blind randomized controlled study where 260 term pregnant women with intact membranes and unfavourable cervix were selected for induction of labour and randomized into two equal groups (30 ml- and 60 ml- groups) from October, 2019 to July 2020. Each participant had cervical ripening with the catheter bulb inflated with either 30 ml or 60 ml of sterile water (as assigned to the individual). After achieving favourable cervix (BS ≥6), oxytocin titration was commenced and the labour monitored with the outcomes well documented and statistically analysed.Results: Mean duration to favourable Bishop Score significantly reduced in the 60 ml group (10.8 hours±2.99) as against 12.7 hours±10.0 in 30ml group (p=0.038). Mean duration of active phase of labour was significantly reduced in 60 ml group (5.6 hours±2.4) as against 8.4 hours±3.2 in 30 ml group (p=0.010). Caesarean delivery rate was significantly reduced in the 60 ml groups (p=0.027).Conclusions: The use of 60 ml inflated Foley’s balloon catheter when compared with 30mls to ripen the cervix effectively reduced the duration to favourable Bishop Score, duration of the active phase of labour and the rate of Caesarean sections.  

scholarly journals Efficacy of Dinoprostone Vaginal Pessary for Cervical Ripening and Induction of Labour

2021 ◽  
Vol 10 (12) ◽  
pp. 873-877
Author(s):  
Mamatha C ◽  
Sarmishta M ◽  
Dhanalakshmi M.G
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Active Phase ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Time Interval ◽  
Delivery Time ◽  
Phase Time ◽  
Vaginal Pessary

BACKGROUND To evaluate the efficacy of dinoprostone vaginal pessary for cervical ripening and labour induction in term pregnant women. METHODS This was a prospective observational study conducted at Sri Ramachandra Institute of Higher Education and Research from September 2016 to September 2018. The study included pregnant women with singleton pregnancy and gestational age (GA) between 37 weeks and 41 weeks of gestation. The estimated sample size was 100. All 100 women were induced with dinoprostone vaginal pessary. RESULTS The average induction to active phase interval was 10 hours 58 minutes. About 60.3 % of primigravida had an active phase time interval of 12 hours 03 minutes; and 95.2 % of primigravida delivered < 24 hours with a mean induction to delivery time interval of 17 hours 36 minutes. 4 % of primigravida had failed induction. About 84.8 % of multigravida delivered with mean induction to active phase time interval of 08 hours 57 minutes and 100 % of multigravida delivered < 24 hours with a mean induction to delivery time interval of 12 hours 19 minutes. Out of 100 patients, 80 % of patients delivered by spontaneous vaginal delivery with episiotomy, 5 % of patients delivered by assisted vaginal delivery with episiotomy and 15 % of patients delivered by Caesarean section. Almost 97 % of multiparous women delivered vaginally. No adverse maternal and neonatal outcome was noted in the present study. CONCLUSIONS Dinoprostone vaginal pessary is highly effective in the induction of labour at term in properly selected cases. In terms of success and failure, dinoprostone vaginal pessary does not differ much from dinoprostone gel. KEY WORDS Labour Induction, Propess, Dinoprostone

Incidence of cesarean delivery after induction of labour with dinoprostone gel at term in nulliparous women with unfavourable bishops score

2017 ◽  
Vol 6 (4) ◽  
pp. 1253
Author(s):  
Kalpana Mehta ◽  
Dhanesh Kumar ◽  
Dharmendra Singh Fathepuriya ◽  
Leena Verma
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Previous History ◽  
Fetal Distress ◽  
Induction Of Labour ◽  
Normal Vaginal Delivery ◽  
Bishop Score ◽  
Nulliparous Women ◽  
History Of ◽  
The Mean

Background: The aim of induction of labour is to achieve vaginal delivery in advance of the normal timing of parturition and to avoid operative delivery. The objective was to study the incidence of instrumental delivery and cesarean section in nulliparous women with unfavourable bishops score at term.Methods: This study was conducted on 200 patients in nulliparous women with unfavourable bishop score, cephalic presentation and no previous history of abortion.Results: The most frequent cause of induction of labour was postdatism (47.5%) followed by PIH (25.5%) and PROM (13%). 143 (71.5%) women had normal vaginal delivery whereas in 54 women (27%) cesarean section was done. 2 women (1%) had forceps application for delivery and remaining 1 women (0.5%) had ventouse delivery. Out of 200 patients 9 had maternal complication of induction of labour.Conclusions: In present study 71.5% women had normal vaginal delivery, 27% had cesarean section. Mean bishop score at induction was 3.31 which improved to 4.0 after 12 hours of gel instillation. The mean induction to delivery interval was 13.38 hrs in present study, 54.5% patients were delivered within 12 hours of gel instillation in this study. Most common indication of cesarean section was failed progress followed by fetal distress.

Epidemiological Profile and Postpartum Outcome for Severe Preeclamptic Patients

2021 ◽  
pp. 45-50
Author(s):  
Suher Dafaus ◽  
Amel Morgham ◽  
Nasreen Osman
Keyword(s):  
Caesarean Section ◽  
Positive Family History ◽  
Previous History ◽  
Severe Preeclampsia ◽  
Intrauterine Fetal Death ◽  
Chronic Hypertension ◽  
Hypertensive Disorder ◽  
Adequate Treatment ◽  
History Of ◽  
The Mean

Background and objective. Preeclampsia is a multisystemic disorder, which involves the placenta, liver, blood, neurological and cardiovascular systems. It is one of the leading causes of maternal and fetal morbidity and mortality. This study aimed at describing the characteristic features for mothers who had severe preeclampsia and to know the complications during puerperium. Methods. A prospective study conducted over a period from February 2009 up to November 2009 involving 100 pre-eclampsia patients admitted and delivered in Aljalaa Maternity Hospital, Tripoli, Libya. Results. The patients mean age was 33.3 +5.9 years. The mean gestational age at admission time was 36.8+3.2 weeks and 64% of them were term. 58% of the patients with severe preeclampsia had a positive family history of chronic hypertension whereas 42% of patients had a previous history of preeclampsia. 40% of patients were primigravida. The mean systolic blood pressure at admission was 164+15.4 mmHg and the mean diastolic pressure was 113+6 mmHg. The common symptoms were headache, abdominal pain, and blurred vision (54%, 37%, and 31% respectively), whereas 9% of the patients presented with the eclamptic fit. The pregnancy in 66% patients ended by caesarean section, 78% of them were emergency caesarean section. The birth weight of 13% of new-borns was less than 1500 grams. Furthermore, 10% diagnosed with intrauterine fetal death (IUFD) antenatally and 9% died after admission to nursery intensive care unit post-delivery. Conclusion. the effects of hypertensive disorder associated with pregnancy could be prevented by close antenatal care particularly for whose had previous history of preeclampsia. In addition; early recognition and adequate treatment, and timely delivery can prevent preeclampsia and will improve maternal and neonatal outcomes.

scholarly journals Comparison of oral, vaginal and sublingual misoprostol for induction of labour in premature rupture of membranes after 34 weeks of gestation: a randomized controlled trial

2018 ◽  
Vol 7 (4) ◽  
pp. 1340
Author(s):  
Chandana Galidevara ◽  
Latha Chaturvedula ◽  
Syed Habeebullah
Keyword(s):  
Apgar Score ◽  
Induction Of Labour ◽  
Delivery Rate ◽  
Labour Induction ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Routes Of Administration ◽  
Active Labour ◽  
Significant Difference ◽  
Sublingual Misoprostol

Background: Purpose of this study was to evaluate the efficacy and safety of different routes of administration of misoprostol - 50µg oral, 25µg vaginal and 50µg sublingual for induction of labour in women with premature rupture of membranes after 34 weeks of gestation.Methods: Women admitted to labour ward with premature rupture of membranes (PROM) after 34 weeks of gestation and requiring induction of labour were randomized into three groups. A total of 246 women participated in the study and were assigned to three groups to receive either 50µg oral misoprostol (n=80) or 25µg vaginal misoprostol(n=83) or 50µg sublingual misoprostol (n=83). The doses were repeated 4 hourly till active labour was established or up to a maximum of 4 doses. Patient factors, induction to delivery intervals, maternal side effects and fetal outcomes were noted.Results: The mean induction to active labour interval was not significantly different in the three groups (oral vs vaginal vs sublingual-7.52±4.8 vs 7.75±4.1 h vs 7.68±5.3 h; p=0.93). There was no significant difference in the induction to delivery time interval among the three misoprostol groups (oral vs vaginal vs sublingual - 10.9± 5.9 h vs 11.2±5.0 h vs 11.4±6.6 h; p= 0.88). Spontaneous vaginal delivery rate, instrumental delivery rate and lower segment ceasarean section rates were comparable among the three groups. The number of neonates with APGAR score <7 (low APGAR) at 1 minute of birth was highest in sublingual group and lowest in vaginal group which was statistically significant (oral vs vaginal vs sublingual, 16% vs 7.2% vs 20.5%; p= 0. 04). APGAR score <7 at 5 minutes was not significantly different among the three groups (oral vs vaginal vs sublingual, 4.8% vs 2.4% vs 7.2%; p=0.2). This implies that the need for immediate resuscitation was more in the sublingual group. Neonatal intensive care admission was least in the vaginal group although the difference was not statistically significant. Sublingual group had a higher rate of hyperstimulation and fetal heart rate abnormalities compared to oral and vaginal groups although these parameters did not reach statistical significance.Conclusions: Oral, vaginal and sublingual routes of administration of misoprostol are equally effective for labour induction in women with premature rupture of membranes after 34 weeks with sublingual route having slightly higher incidence of low APGAR scores at one minute for the neonate.

Role of the audit of delivery methods for optimizing the indications for cesarean section and reducing its frequency in clinical practice

2021 ◽  
Vol 20 (2) ◽  
pp. 44-49
Author(s):  
A.A. Churganova ◽  
◽  
M.Kh. Gurzhikhanova ◽  
F.N. Alieva ◽  
S.I. Fedorina ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Fetal Distress ◽  
Labour Induction ◽  
Efficiency Coefficient ◽  
Delivery Methods ◽  
Robson Classification ◽  
Perinatal Center ◽  
Level 3 ◽  
Narrow Pelvis

Objective. To analyze the frequency of indications for cesarean section (CS) and optimize obstetric tactics on the example of a level 3 perinatal center. Materials and methods. We performed retrospective analysis of 7,672 deliveries. Results. The indications for CS included abnormal labour (150; 6.3%), fetal distress (120; 5%), placental abruption (60; 3%), and narrow pelvis (34; 1.4%). Most often (23%) CS was performed in patients with CS scars. Conclusion. The most important step towards reducing the proportion of CS is the change of the approaches to the use of labour induction methods and assessment of the fetus condition. It is extremely important to develop a comprehensive strategy for choosing an optimal delivery method in women with post-CS scars, as well as to perform thorough analysis of the indications for planned and emergency CS. Key words: caesarean section, Robson classification, efficiency coefficient

Comparison between AFI and DVP in predicting adverse neonatal respiratory outcomes in women with prolonged pregnancy undergoing induction of labour

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Ahmed Elkady ◽  
Dina Yahia Mansour ◽  
Hamada Farag Abu zaid
Keyword(s):  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Neonatal Outcomes ◽  
Induction Of Labour ◽  
University Hospitals ◽  
Amniotic Fluid Index ◽  
Assessment Tests ◽  
Prolonged Pregnancy ◽  
Heart Rate Pattern ◽  
Respiratory Outcomes

Abstract Background The intrapartum management of prolonged pregnancies is aunique challenge to the obstetricians, as the perinatal outcomes areadverse after completed 40 weeks. In such cases, intrapartumasphyxia and meconium aspiration are associated with almost. Objective To comparison between MVP and AFI in predicting neonatal respiratory outcomes in induction of labour in prolonged pregnancies. Patients and Methods The study was a prospective comparative study that was conducted on 266 women with prolonged pregnancy undergoing induction of labour. The patients were recruited from Ain Shams university hospitals during the period from February 2019 to August 2019. Results Amniotic fluid index and MVP were evaluated in 269 women with pregnancies of 40 or more weeks and intact membranes using a 3.5-MHz linear transducer. Both measurements were obtained for each participant by the same obstetrician in one sitting. Oligohydramnios was defined as an AFI of 5 cm or less or an DVP of 1 cm or less. External cardiotocography was performed during intrapartum period in all cases. Fetal distress was diagnosed when any one of the nonreassuring fetal heart rate pattern occurred or when the Apgar score at birth was 6 or less. The results were analyzed by the chi(2) and the t tests. Conclusion The use of the AFI and SDVP is useful in predicting neonatal outcomes in the induction of labor in prolonged pregnancies. The SDVP measurement appears to be the more appropriate method for predicting neonatal outcomes. The same observation was found when AFI and SDVP were combined. It is also logical to recommend that only one method should be used for fetal assessment tests.

scholarly journals Maternal Coronavirus Infections and Neonates Born to Mothers with SARS-CoV-2: A Systematic Review

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 511
Author(s):  
Waldemar Naves do Amaral ◽  
Carolina Leão de Moraes ◽  
Ana Paula dos Santos Rodrigues ◽  
Matias Noll ◽  
Jalsi Tacon Arruda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Fetal Distress ◽  
Intrauterine Fetal Death ◽  
Fetal Outcomes ◽  
Fetal Movements ◽  
Pregnancy And Delivery ◽  
The Impact

The coronavirus disease 2019 (COVID-19) pandemic is continuously affecting the lives of all people. Understanding the impact of COVID-19 on pregnancy in terms of morbidity, mortality, and perinatal maternal and fetal outcomes is essential to propose strategies for prevention and infection control. Here, we conducted a systematic review to investigate pregnant women infected with COVID-19 in terms of signs and symptoms, type of delivery, comorbidities, maternal and neonatal outcomes, and the possibility of vertical transmission. A search on Embase and PubMed databases was performed on 31 October 2020. Observational studies and case reports on pregnant women infected with COVID-19 were included without language restrictions. The 70 selected studies included a total of 1457 pregnant women diagnosed with COVID-19 in the first, second, and third trimesters of pregnancy. The most common signs and symptoms were fever, cough, and nausea. The most frequent comorbidities were obesity, hypertensive disorders, and gestational diabetes. Among maternal and fetal outcomes, premature birth (n = 64), maternal death (n = 15), intrauterine fetal death or neonatal death (n = 16), cases of intrauterine fetal distress (n = 28), miscarriage (n = 7), decreased fetal movements (n = 19), and severe neonatal asphyxia (n = 5) were the most frequent. Thirty-nine newborns tested positive for SARS-CoV-2. Additionally, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA was detected in the placenta (n = 13) and breast milk (n = 6). This review indicates that COVID-19 during pregnancy can result in maternal, fetal, and neonatal complications. In addition, SARS-CoV-2 viral exposure of neonates during pregnancy and delivery cannot be ruled out. Thus, we highlight the need for long-term follow-up of newborns from mothers diagnosed with COVID-19 to establish the full implications of SARS-CoV-2 infection in these children.

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