scholarly journals Induction of Labour in Prelabour Rupture of Membranes with or without Cervical Ripening with Prostaglandin E2

2014 ◽  
Vol 2 (1) ◽  
pp. 4
Author(s):  
Shreyashi Aryal ◽  
Chanda Karki
Keyword(s):  
Caesarean Section ◽  
Prostaglandin E2 ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Cervical Priming ◽  
Group 5 ◽  
A Prospective Study

Objective: To compare the outcome of induction of labour with titrated dose of oxytocin with or without pre induction cervical ripening using prostaglandin E2. Methods: This is a prospective study. Sixty women with prelabour rupture of membranes (PROM) and Bishops score of less than six were randomly assigned to either immediate induction with intravenous oxytocin drip or induction with intravenous oxytocin drip preceded by cervical priming with prostaglandin E2 (PGE2) gel 0.5mg instilled intracervically. These two groups were compared regarding the mode of delivery, induction to delivery interval and maternal and neonatal morbidities. Results: Cervical priming with PGE2 resulted in lesser number of caesarean section (5 Vs. 12) and lower incidence of meconium stained liquor (n=6 Vs. n=2). Induction to vaginal delivery interval was shorter when cervical priming was done (5.4 hrs Vs 7.9 hrs). The maternal morbidity was negligible (<1%) in both the groups. The number of neonates with birth asphyxia (n=2) and the need for their resuscitation (n=2) was more in the oxytocin group but the need of antibiotics for the neonates was more in PGE2 group (5% Vs. 3%). Conclusion: Induction of labor with oxytocin, with or without cervical priming with vaginal PGE2 gel, are both reasonable options in cases of PROM, since they result in statistically non significant rates of maternal and neonatal morbidities and caesarean section. Cervical priming with prostaglandin results in higher rate of vaginal delivery and shorter induction to vaginal delivery interval and this is viewed as an advantage to the mother.

scholarly journals Incidence and indications of LSCS among Doctors Community of Chattogram

2021 ◽  
Vol 20 (2) ◽  
pp. 37-40
Author(s):  
Adiba Malik ◽  
Kamrun Nessa ◽  
Yasmin Ara Begum ◽  
M Jalal Uddin ◽  
Aklima Sultana ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Left Ventricular ◽  
Subsequent Pregnancy ◽  
Cross Sectional ◽  
Lower Segment Caesarean Section

Background: Lower segment caesarean section (LSCS) is a surgical intervention, which is carried out to ensure the safety of mother and baby when vaginal delivery is not possible or when danger to mother and baby would be greater with vaginal delivery. This study is designed to identify indication of LSCS and detect complications if any among the respondents. Materials and methods: Cross sectional descriptive study where 95 female doctors of Chattogram were selected by convenient sampling without knowing their mode of delivery and if it is LSCS then indication of LSCS , maternal and neonatal complications were noted. Results: Age of the respondents at the time of interview were noted and most of them were between 31- 40 years 52 (55%), regarding income most of them between 100000 -200000 42(44%) most of the delivery occurred in the private clinics 92 (70%) regarding mode of delivery, LSCS was 92 (70%) vaginal delivery 40 (30%) regarding indications of LSCS most common was repeat caesarean section 27 (29%) and second common was LSCS due to maternal interest 18 (20%) and others were severe preeclampsia 10 (11%) fetal distress 08(09%) placenta previa, Diabetes with big baby, cephalopelvic disproportion, PROM with non progression of labour. PPH was the most common complication 05 (63%), next was paralytic ileus 02 (25%) and left ventricular failure 01 (12%). Common neonatal comoplications were low birth weight baby 904 (40%), prematurity 03 (30%) and birth asphyxia 03 (03%). Conclusion: LSCS is a major surgical procedure for delivery. Inspite of its low maternal morbidity and mortality due to improved surgical technique, modern aneasthetic skill and availability of blood and blood products, still it carries a slightly greater risk in subsequent pregnancy, so we should be rational in doing primary caesarean section. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 37-40

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.

scholarly journals Comparison of clinical outcomes following CuT-380A insertion in postplacental period with interval insertion

2017 ◽  
Vol 6 (9) ◽  
pp. 4111
Author(s):  
Divya Chauhan ◽  
Shalini Gainder
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Abnormal Uterine Bleeding ◽  
Complication Rates ◽  
Expulsion Rate ◽  
Interval Group ◽  
Obstetrics And Gynaecology ◽  
Significant Difference ◽  
A Prospective Study

Background: Postplacental intra-uterine device has many benefits like providing contraception immediately after childbirth, non-interference with lactation and high efficacy. However, concerns about its safety have led to decreased use of this method of contraception. Hence, this study aims to compare the complication rates following insertion of immediate postplacental IUCD (PPIUCD) with interval insertion.Methods: This is a prospective study conducted under the Department of Obstetrics and Gynaecology in PGIMER, Chandigarh. 196 women were included in the study. Women were divided in two groups, those who were inserted with immediate postplacental IUCD versus those who had IUCD insertion in interval period. The two groups were followed up for a period of 6 months and complications were recorded. The PPIUCD group was further subdivided into 2 subgroups based on mode of delivery, vaginal delivery and caesarean section. These PPIUCD subgroups were also compared.Results: There was no statistically significant difference in the incidence of pelvic pain, infection, abnormal uterine bleeding and expulsion between the PPIUCD and interval group. However, when the PPIUCD subgroups were compared, it was seen that no woman in caesarean section subgroup had expulsion of IUCD whereas 9.8% women had expulsion in the vaginal delivery PPIUCD subgroup.Conclusions: Postplacental and interval IUCD seem to be comparable for the incidence of various complications. However, intra-caesarean PPIUCD insertion seems to have a much lower expulsion rate as compared to vaginal delivery PPIUCD insertion.

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 Role of mifepristone in induction of labour in pregnant women with previous lower section caesarean section with IUFD in late preterm and term pregnancies

2017 ◽  
Vol 6 (2) ◽  
pp. 707
Author(s):  
Ram Kanwar Deora ◽  
Nikhila G. Shetty
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Induction Of Labour ◽  
Late Preterm ◽  
Cervical Ripening ◽  
Fetal Demise ◽  
Short Term Study ◽  
Score Analysis ◽  
Near Term

Background: The objective of the study was to evaluate efficacy and safety of oral mifepristone for preinduction cervical ripening and induction of labour in late preterm and term pregnancies with previous caesarean section with intrauterine fetal demiseMethods: This prospective short term study was conducted at Umaid hospital SNMC Jodhpur Rajasthan January 2016 to November 2016. 100 subjects with previous uses beyond 34 week with intrauterine fetal demise and bishop’s score<6 were included. Tablet mifepristone 200mg was given orally after taking written in informed consent. The same dose was repeated after 24 hour according to bishop’s score. Analysis was done with respect to maternal outcome of vaginal delivery, CS, duration of labour.Results: Among 100 subjects, 97 delivered vaginally (97%) delivered within 72 hour of 1% dose. Improvement of bishop’s score was observed in 1 subject (1%), which later required augmentation by oxytocin followed by vaginal delivery.1 subject (2%) failed to respond and required caesarean section, 72 hour after given of 1st dose.Conclusions: Mifepristone can be used safely and effectively for induction of labour in previous one and two LSCS near term and term pregnancies to avoid CS rates.

scholarly journals Comparative study of mifepristone versus balloon catheter for cervical ripening and induction of labour in previous caesarean section

2020 ◽  
Vol 9 (6) ◽  
pp. 2504
Author(s):  
Krishna Dahiya ◽  
Nisha Yadav ◽  
Pushpa Dahiya ◽  
Isha Nandal
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Balloon Catheter ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Catheter Group ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background: The objective of this present study was to compare the efficacy of oral mifepristone and balloon catheter for cervical ripening and induction of labour in women with previous caesarean section.Methods: This prospective study was conducted on 130 pregnant women with previous 1 caesarean section and term singleton pregnancy admitted for induction of labour. Sixty-five patients were induced with oral mifepristone (Group 1) and in another 65 transcervical balloon catheter (Group 2) was inserted for induction of labour. Both groups were than compared with respect to change in bishop score, induction to active phase interval, induction to delivery interval, dose of oxytocin in milliunits, mode of delivery, maternal complication and fetal outcomes.Results: Change in bishop score after induction was more in mifepristone group than balloon catheter group (p=0.002). Favorable bishop score was more in Group 1 (83.07%) than Group 2 (66%), p=0.05. There was significant difference in mode of delivery between two groups, 61.53% in Group 1, and 32.3% in Group 2 delivered vaginally (p<0.001).Conclusions: Present study showed that mifepristone is an alternative to balloon catheter for induction of labour in women with previous one caesarean section with poor bishop score.

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 single versus repeat instillation of intravaginal prostaglandin E2 gel for induction of labour

2020 ◽  
Vol 9 (11) ◽  
pp. 4482
Author(s):  
Aastha Mashkaria ◽  
Sushma R. Shah ◽  
Ami V. Mehta ◽  
Payal P. Panchal ◽  
Aashka Mashkaria
Keyword(s):  
Prostaglandin E2 ◽  
Vaginal Delivery ◽  
Fetal Outcome ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Repeat Dose ◽  
Uterine Hyperstimulation ◽  
Group A ◽  
Failed Induction ◽  
Group B

Background: The aim of induction was to achieve successful vaginal delivery where continuation of pregnancy is not desirable. Unfavourable cervix is one of the main causes of failed induction. Introduction of intravaginal prostaglandins E2 has revolutionised the method of cervical ripening. More than one dose of prostaglandin E2 (PGE2) gel may be necessary to facilitate cervical ripening and increase the chances of vaginal delivery.Methods: This retrospective study was done to find the efficacy of repeat instillation of intravaginal PGE2 gel and to compare the maternal and fetal outcome between the single instillation group and repeat instillation group. The women who went into labour or achieved cervical ripening with a single instillation of PGE2 gel forms Group A. Those who required repeat instillation of PGE2 gel forms Group B. Both groups were compared for specific parameters.Results: Primigravidas required repeat instillation. Postdated pregnancy was the most common indication for induction of labour. 45.2% of primis required only single dose and 54.8% required repeat dose. About two third (77.8%) of multipara required only one dose and a third of multipara needed repeat dose. In Group A 90.7% had vaginal delivery, 9.3% had Caesarean section. Group B 95.7% had vaginal delivery and 4.3% had Caesarean section.Conclusions: Prostaglandins PGE2 (0.5 mg) gel is recommended to be used intravaginally. We applied 2 doses of intravaginal PGE2, 24 hours apart and no complications like uterine hyperstimulation was seen. There is no increased fetal risk with repeat instillation of intravaginal PGE2 gel.

MATERNOFETAL OUTCOME IN MECONIUM STAINED LIQUOR AT TERTIARY CARE HOSPITAL

2021 ◽  
pp. 48-50
Author(s):  
Neha Agarwal ◽  
Samta Bali Rathore ◽  
Shivani Baberwal-
Keyword(s):  
Caesarean Section ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Meconium Aspiration ◽  
Induced Hypertension

BACKGROUND: Occurance of meconium-stained amniotic uid (MSAF) during labour may be considered as a measure for prediction of poor fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia ,resulting in perinatal as well as neonatal morbidity and mortality. It constitutes about 5% of deliveries with meconium stained amniotic uid and death results in about 12% of infants with MAS. METHODS: 40 cases of meconium stained liquor detected after spontaneous or artical rupture of membranes taken during labour from june 2020 to december 2020 and their outcome in terms of mode of delivery(whether vaginal delivery or lower segment caesarean section) and fetal outcome and associated maternal high risk were studied RESULT: Anemia was co existant in around 15%, pregnancy induced hypertension(PIH) in 25%and premature rupture of membrane in 10%.Pregnancies complicated with Pregnancy induced hypertension had signicant higher rate of meconium stained liquor among all cases. Caesarean Section was commonly performed in meconium stained amniotic uid cases and accounted for about 65%of all cases. CONCLUSIONS: Meconium Stained amniotic uid increases the chances of caesarean rates,leading to birth asphyxia ,Meconium Aspiration Syndrome and hence increases the chances of neonatal intensive unit admission.

scholarly journals On demand caesarean section: What’s women’s attitude?

1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
University Teaching ◽  
Normal Vaginal Delivery ◽  
On Demand ◽  
Assisted Delivery ◽  
The Right

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15

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