scholarly journals Vaginal Prostaglandin E2 pessary versus gel in induction of labor at term

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Humaira Akram ◽  
Zohra Khan ◽  
Tabinad Rana
Keyword(s):  
Cost Effectiveness ◽  
Side Effects ◽  
Prostaglandin E2 ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Bishop Score ◽  
Vaginal Pessary ◽  
Number Of Patients

Objective: To compare the prostaglandin E2 Vaginal pessary and gel with respect to cervical ripening, labour out come, side effects and cost effectiveness in induction of labour at term. Design: Experimental study. Place and duration of study: Lady Willingdon Hospital, Lahore February to July, 2005. Subjects and Methods: The trial was conducted on two group of patient for labour induction such that one group (n=30) received PGE2 vaginal pessary 6 hourly to maximum of 3 doses. Other group (n=30) received PGE2 gel at 6 hourly interval upto 2 doses. Labour induction, number of doses applied, need of augmentation, side effects, induction to delivery interval, mode of delivery, neonatal outcome and cost effectiveness were the main outcome measures. Results: Our results depicted that PGE2 gel produced favourable bishop score more rapidly and initiating uterine contraction simultaneously than PGE2 pessary. Few patients required oxytocin augmentation in gel group (P<0.05). There was no statistically significant d ifference in number of patients delivering vaginally with in 24 hours, the neonatal outcome and cost effectiveness in two groups (P>0.05). However, more side effects such as uterine contractions, abnormalities, and fetal distress observed in gel group (P<0.05). Conclusion: The PGE2 pessary was safe and easily applied, but PGE2 intracervical gel was more effective as it achieved greater changes in mean bishop score. However, more side effects encountered with gel category.

scholarly journals INDUCTION OF LABOR;

2017 ◽  
Vol 24 (02) ◽  
pp. 288-292
Author(s):  
Raheela Baloch ◽  
Nigar Jabeen ◽  
Sana Zahiruddin ◽  
Ms. Kiran Mawani
Keyword(s):  
Side Effects ◽  
Prostaglandin E2 ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Efficacy And Safety ◽  
Vaginal Deliveries ◽  
Number Of Patients

Efficacy and safety of intra-vaginal prostaglandin E2 pessary for induction ofLabor. Objectives: To evaluate the efficacy and safety of intra-vaginal prostaglandin E2 pessaryfor induction of Labor. Study Design: Case control study. Setting: Gynecological and obstetricward of Liaquat University of Medical and Health Sciences Hospital, Hyderabad. Period: 14 Feb2012 to 13 Feb 2013. Study Population: All the Pregnant women at term or post term admittedin gynae ward from 14th February 2012 to 13th February 2013. Results: 100 women recruitedin the study, study carried out at Gynecological ward of Liaquat University of Medical and HealthSciences Hospital Hyderabad. Analysis of booking status listed in Table-I revealed that 68% (n= 68) were un-booked having no antenatal care and 32.0% (n = 32) were booked. There wereno protocol violation, relation to the parity listed in Table-II showed maximum number of patients(n = 62) 62.0% Primigravida and (n = 38) 38.0% multigravidas were include. Age distributionis listed in Table-III maximum patients (n = 49) 49.0% at age between 26 - 35 years, 35 (35.0%)were between 20 - 25 years, 10 (10.0%) were >35 years and 06 (6.0%) patients were belong toless than 20 years. Regarding the gestational age 57 (57.0%) patients in our study presentedbetween 37 - 39 weeks of gestation. However, 47 (47.0%) patients were at 40 - >40 weeksof gestation showed in the (Table-IV). Indication for cervical ripening and induction of laboris listed on Table-V commonest indication was pregnancy induced hypertension followed byprolonged pregnancy, and IUGR etc. Table-VI shows the Bishop score 30 (30.0%) had BishopScore 2 – 3, while 70(70.00%) had a bishop score 4-5. Table-VII shows induction-deliveryinterval, Greater number of women (66/100) delivered within 24 hours of start of induction.Table-VIII showed mode of delivery, majority of the women had normal vaginal deliveries 64.00while 16 deliveries by assisted vaginal deliveries while in remaining 20 cases caesarean sectiondone. Table-IX shows four babies had an Apgar score 4/10 at end of 1 min and 7/10 at end of5 min, whereas 96 babies had an Apgar score of 9/10 in 1 min. The indications for caesareansection are shown in Table-X. There were 09(9%) cases of failed induction, 11 cases of a fetaldistress (Meconium stained liquor). There was no increased incidence of neonatal sepsis orChorioamniotis or puerperal sepsis in any of our patients. No perinatal morbidity or mortalityor any severe maternal complications were noted while mild side effects were noted which ismentioned in (Table-XI). Conclusion: In developed countries prostaglandin E2 are widely usedfor ripening of unfavorable cervix in induction of labor but patient response vomiting, diarrhea,tachycardia, and fever are commonly observed minor side effects. Induction with Prostaglandinreduced the rate of pregnancies progressing beyond 41 weeks and related feto-maternalmorbidity and mortality. After excluding contra indication all women should be offered inductionat 41 completed weeks. Induction with prostaglandin with medical disorder like preeclampsia issafe and better feto maternal outcome.

scholarly journals A Comparison of Orally Administered Misoprostol With Vaginally Administered Misoprostol For Cervical Ripening And Labour Induction

KYAMC Journal ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 668-672 ◽  
Author(s):  
Sohana Siddique ◽  
Muhammad Jahangir Howlader ◽  
Joysree Saha ◽  
Kazi Shahnaz Begum
Keyword(s):  
Mode Of Delivery ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Efficacy And Safety ◽  
Cross Sectional ◽  
Oral Misoprostol ◽  
Number Of Patients ◽  
Oral Group ◽  
Vaginal Misoprostol ◽  
Duration Of Pregnancy

Objective: To compare efficacy and safety of oral misoprostol over vaginal misoprostol for labour induction.Materials and Methods: This is a cross sectional interventional hospital based comparative study which was carried in the department of Obstetrics and Gynecology in DMCH from 01.07.2008 to 31.12.2008.Results: Almost equal number of patients delivered vaginally spontaneously in both group, there is no association between route of administration and mode of delivery. Nausea,vomiting occurred more in oral group and uterine hypertonicity more in vaginal group.Conclusion: In this study, 50 patients were randomly selected for oral group and 50 patients for vaginal group. There were no significant differences regarding age, duration of pregnancy, Bishop's score and indication of induction of labour.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 668-672

scholarly journals Use of intracervical Foley catheter for pre-induction cervical ripening in women planned for vaginal birth after previous caesarean section

2020 ◽  
Vol 9 (12) ◽  
pp. 4927
Author(s):  
Sheenam Jakhar ◽  
Veena Ganju Malla
Keyword(s):  
Caesarean Section ◽  
Foley Catheter ◽  
Mode Of Delivery ◽  
Vaginal Birth ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Previous Caesarean Section ◽  
Bishop Score ◽  
Increased Risk

Background: Vaginal birth after previous caesarean section is challenging for obstetricians due to increased risk of uterine rupture. Common methods for labour induction in post caesarean pregnancies are membrane sweeping, balloon catheters, prostaglandins (PGE2), and oxytocin. As currently available data is limited, the evidence of safest method of induction is lacking. The present study aimed to assess the effectiveness of intra-cervical Foley catheter for pre-induction cervical ripening in women planned for vaginal birth after caesarean section.Methods: This prospective cross-sectional study included 24 pregnant women with a history of previous caesarean section, admitted for induction of labour. Induction was performed in patients with unfavourable modified Bishop Score by intra-cervical Foley catheter. The change in modified Bishop Score, oxytocin requirement, induction-delivery interval, mode of delivery, maternal complications and neonatal outcome were observed.Results: There was significant improvement in modified BS noted at the end of trans-cervical Foley catheter induction and this improvement in mean of modified BS was observed to be statistically significant (p<0.0001). The vaginal delivery rate was 29.2% while 70.8% of patients underwent caesarean section. No significant maternal or foetal complications were observed with Foley catheter induction except for one case of vaginal bleeding. There was no case of intrapartum or postpartum maternal infection.Conclusions: Foley catheter may be a cheap and effective method for pre-induction cervical ripening and induction of labour in patients with previous caesarean section.

scholarly journals A prospective randomized trial of trans cervical Foley’s with extra amniotic saline infusion versus intra cervical prostaglandin E2 gel for induction of labour setting

2017 ◽  
Vol 6 (12) ◽  
pp. 5613 ◽  
Author(s):  
Sunil Kumar ◽  
Rita D. ◽  
R. M. Desai ◽  
Mohan Kumar K. R. ◽  
Dhanalaxmi .
Keyword(s):  
Prostaglandin E2 ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Saline Infusion ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Post Induction ◽  
The Mean ◽  
Group B

Background: This study evaluated the effectiveness of Extra-amniotic saline infusion (EASI) in comparison with that of intracervical Prostaglandin E2 (PGE2) gel for cervical ripening and induction of labour.Methods: The study conducted in SDM College of Medical College Dharwad, Department of OBG, from December 2012 to November 2013. Consecutive patients with unfavorable cervices requiring pre-induction cervical ripening and induction of labour for various indications were asked to participate in this study. 50 patients (Group A) underwent extra amniotic saline infusion and 50 patients (Group B) underwent PGE2 gel application. Post induction augmentation if required was administered. Labour profile outcomes were compared between the groups.Results: Results were comparable in terms of maternal age, indication for induction in majority of cases, pre-induction Bishop Score, mode of delivery, complications and side effects, neonatal complications, and Apgar Score. The mean post induction Bishop Score was higher in EASI group by an average of 9. The mean duration of augmentation was more in PGE2 group by an average of 2 hrs. The induction delivery interval (IDI) was prolonged by an average of 3.5 hours in PGE2 group.Conclusions: For pre-induction cervical ripening the extra amniotic saline infusion is valid alternative for the PGE2 gel. Both the modes of induction were equally safe and effective in terms of mode of delivery and Apgar Score. EASI, however, had rapid cervical ripening and shorter induction delivery interval.

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 Use of Misoprostol in Pregnancy- A Review Article

2012 ◽  
Vol 22 (2) ◽  
pp. 94-98
Author(s):  
Syeda Ummay Kulsum ◽  
Sabera Khatun ◽  
SM Shahnawaz Bin Tabib
Keyword(s):  
Prostaglandin E2 ◽  
Review Article ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Pharmacological Agents ◽  
Tablet Form ◽  
Cytoprotective Agent ◽  
Medicine Today

Prostaglandins are the pharmacological agents used for induction of labour and augmentation of labour. Prostaglandin E2 gel is used for cervical ripening and induction of labour. These are however, costly and need to be stored in a refrigerator at a temperature of 2 - 8°C, half life 18 months. The Tablet form of prostaglandin E2 is not available in Bangladesh. Misoprostol, a synthetic prostaglandin (PG) E1 analogue is used orally for the treatment of gastric and duodenal ulcer and used as a cytoprotective agent. It was first used for labour induction in 1987. Prostaglandin can be used in several gynaecological and obstetric conditions. It can be given through several routes. This article will elaborately delinate the role of misoprostol, a prostaglandin in obstetrics and gynaecological conditions. Medicine Today 2010 Volume 22 Number 02 Page 94-98 DOI: http://dx.doi.org/10.3329/medtoday.v22i2.12443

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.

scholarly journals A Randomised Controlled Trial Comparing Intravaginal Misoprostol and Intracervical Dinoprostone in Pre Induction Cervical Ripening

2013 ◽  
Vol 1 (03) ◽  
pp. 45-54
Author(s):  
B. H. Radhika ◽  
S. Soundara Raghavan
Keyword(s):  
Controlled Trial ◽  
Mode Of Delivery ◽  
Primary Outcome Measure ◽  
Cervical Ripening ◽  
Secondary Outcome ◽  
Bishop Score ◽  
Intervention Delivery ◽  
Misoprostol Group ◽  
Randomised Controlled ◽  
Mean Cost

Objective: To compare the efficacy and safety of intravaginal misoprostol with intracervical dinoprostone for preinduction cervical ripening. Material andMethods: It was a randomized controlled trial conducted at department of obstetrics and gynecology, JIPMER, Puducherry. Three hundred women with Bishop score of 6, were assigned randomly to receive either intravaginal misoprostol 25 μg every four hours for four doses, and intracervical dinoprostone gel 0.5 mg every eight hours for two doses. (one hundred women in each group). Oxytocin was initiated as per standardized protocol, if the cervix was favourable. If the cervical ripening was unsuccessful (Bishop score 6) after the maximum doses of drugs in both the groups, then further treatment was individualized. Efficacy and cost of the drugs were compared in both groups. Results: Primary outcome measure was change in Bishop score. Mean Bishop score change at the end of 16 hours was significantly higher in the misoprostol group, (2.57±0.59) compared to dinoprostone group (2.17±0.10, p=0.016). This finding was inspite of the fact that the dinoprostone group had higher Bishop score prior to the ripening.(3.55±0.56 vs 3.28±0.77, p=0.006). Secondary outcome measures such as mean intervention-delivery interval, oxytocin requirement, mode of delivery, maternal and neonatal outcomes were similar in both the groups. Overall mean cost of ripening agent per patient was significantly less in the misoprostol group, (22.56±93.16 rupees) compared to dinoprostone group (493.89±173.99 rupees, p0.0001).Conclusion: Low dose misoprostol is as effective as dinoprostone in cervical ripening and demonstrates similar fetal and maternal safety profile.

scholarly journals A Comparative Study of Extra-Amniotic Saline Infusion (EASI), Foley’s Catheter and Prostaglandin E2(PGE2) gel for Pre-Induction Cervical Ripening

2018 ◽  
Vol 1 (2) ◽  
pp. 28-32
Author(s):  
Keshar B. Dhakal ◽  
S. Rai Dhakal
Keyword(s):  
Mode Of Delivery ◽  
Cost Effective ◽  
Saline Infusion ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Delivery Time ◽  
Successful Induction ◽  
The Mean ◽  
Time Changes ◽  
Foley’S Catheter

Introduction: Cervical ripening is essential for successful induction of labor. The aim of the study is to compare the efficacy, safety and cost-effectiveness of extra-amniotic saline infusion, Foley’s catheter and intra-cervical PGE2 gel for pre-induction cervical ripening. Methods: A total 150 women having indications of labor induction were randomly assigned equally into three groups: EASI, Foley’s catheter and PGE2 gel. Eligible full-term pregnancy with Bishop score 4 or less was recruited for the study. Computer generated randomization method and random numbers were used to allocate cases into three groups. Data were analyzed by SPSS. The induction to cervical ripening interval, induction to delivery time, changes in the Bishop Score, mode of delivery and cost were assessed. Results: Majority of the cases was primigravida (67.3%) and the most common indication of induction was postdated pregnancy (72%). The mean time for induction to cervical ripening interval was shorter in Foley’s catheter and EASI than PGE2 (6.92 & 5.69 vs 11.08 (P<0.006). Majority of cases in Foley’s catheter and EASI achieved the Bishop score of 7 or more within 24 hours of induction as compared to PGE2 (88% & 84% vs 54%, P<0.000). The mean induction to delivery time is found shorter in EASI and Foley’s catheter than PGE2 (14.95hrs & 16.84hrs vs 23.18hrs). Conclusions: Foley’s catheter and extra-amniotic saline infusion (EASI) are the most efficacious, cost effective and safe methods of cervical ripening as compared to PGE2 gel.

scholarly journals Mifepristone as pre-induction cervical ripening agent: a review article

2019 ◽  
Vol 8 (11) ◽  
pp. 4636
Author(s):  
Nikita . ◽  
Seetesh Ghose ◽  
Setu Rathod
Keyword(s):  
Adverse Effects ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Review Article ◽  
Induction Of Labour ◽  
Present Review ◽  
Cervical Ripening ◽  
Successful Induction

Induction of labour after the period of viability by any methods medical, surgical or combined, for the purpose of vaginal delivery. The success of induction, to a great extent, depend upon pre-induction cervical status i.e. cervical ripening. So, ripening of cervix prior to induction i.e. pre-induction cervical ripening is one of the important steps for successful induction of labour. There are different methods for cervical ripening like prostaglandins (PGE). However, use of prostaglandins (PGE) and oxytocin as labour inducing agent has its own adverse effects on maternal and perinatal outcome. So, constant efforts are made for the less use of uterotonins. The present review aims to study the efficacy of oral Mifepristone for improvement in Bishop’s score, requirement of additional uterotonics, induction delivery interval, mode of delivery and neonatal outcome. Electronic databases were searched by using keywords ‘Mifepristone, RU486, PGE2 gel, Cervical ripening, Bishop’s score and Induction of labour’ and eleven articles were found from 2009 to 2018 which fulfils our study criteria and thus they were taken for review. Based on all the studies, Mifepristone appears to be effective cervical ripening in comparison to other agents with significant improvement in Bishop’s score, higher vaginal delivery rate, shorter induction delivery interval and good neonatal outcome.

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