scholarly journals LABOUR INDUCTION;

2018 ◽  
Vol 21 (05) ◽  
pp. 1070-1074
Author(s):  
Samar Ameen
Keyword(s):  
Vaginal Delivery ◽  
Randomized Study ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Labour Induction ◽  
Large Numbers ◽  
Significant Difference ◽  
Oxytocin Infusion ◽  
Misoprostol Group ◽  
Lactated Ringer's Solution

Objective: To compare the efficacy of misoprostol 50ug (sublingual) incomparison with oxytocin infusion than for induction of labour in cases of PROM (prematurerupture of membrane at term). Design: Prospective randomized study. Setting: Mujahid TrustHospital, Faisalabad. Duration: Conducted from Dec 2006 to April 2008. Methods: Womenwere randomized to receive either 50 microgram of sublingual misoprostol every 4 hours withRinger’s lactate solution or oxytocin infusion 10 lU in one litre of Lactated Ringer’s solution witha sublingual placebo. Main outcome measures: The number of women delivering vaginallywithin 24 hours of labour induction. Results: Fifty two women (83%) in misoprostol group and48 (77 %>) in oxytocin group delivered vaginally within 24 hours [relative risk (RR)1.1. However,the induction to vaginal delivery was significantly shorter in the misoprostol group 15+3.7 hourscompared with the oxytocin group 18+4.1. The incidence of tachysystole was more than threefolds higher in misoprostol than in the oxytocin group (14%) versus 4.3%) RR3.3) but this wasnot statistically significant. There was no significant difference in the incidence of hypertonusor hyperstimulation syndrome, mode of delivery intervention for fetal distress or neonataloutcomes between the two groups. Conclusions: The group of women received misoprostolfor labour induction were found more successful in achieving vaginal delivery in comparativelyshorter time and more acceptable to patients. Further studies on safety with large numbers ofwomen need to be conducted before routine use.

scholarly journals I. V. Oxytocin versus oral Misoprostol for augmentation of labour, associated complications and effect on neonatal wellbeing

2018 ◽  
Vol 7 (8) ◽  
pp. 3338
Author(s):  
Swapnil Wilson ◽  
Subrata Das
Keyword(s):  
Fetal Distress ◽  
Singleton Pregnancy ◽  
Group Status ◽  
Medical College ◽  
Oral Misoprostol ◽  
Significant Difference ◽  
Oxytocin Infusion ◽  
Misoprostol Group ◽  
Prolonged Labor ◽  
Meconium Staining

Background: The complications of prolonged labor are well recognized and the caesarean section has been used liberally. But even then, prolonged labor continues to be a problem. This could be due to weak uterine contractions or poor cervical dilatation. The problem can be overcome with the use of oxytocic drugs. The aim of the study was to compare the efficacy, adverse effects, safety, and feto-maternal outcome of the ARM and oral misoprostol with Artificial Rupture of Membrane (ARM) and oxytocin infusion for labor augmentation.Methods: This prospective study was conducted in the labor room of NRS Medical College and Hospital Kolkata and included 100 primigravidae women carrying singleton pregnancy at term with spontaneous onset of labor.Results: The result findings of the present study show that the prolonged labor was the major indication for LSCS in both the groups. There was a significantly higher subjects (P <0.05*) had fetal distress or fetal bradycardia, meconium staining of liquor, Tachysystole in the misoprostol group, compared to oxytocin group. No significant difference was observed among the groups with respect to neonatal wellbeing.Conclusions: Both the agents i.e. oral misoprostol and I.V. oxytocin shortens the duration of labor effectively and are effective for augmentation of labor. Apart from Tachysystole and meconium staining of liquor and fetal distress the incidence of any other complication was not significantly more in the oral misoprostol group when compared with oxytocin group. Status of the neonate was almost similar in both the groups.

scholarly journals A comparative study of 25 mcg vs 50 mcg of vaginal misoprostol for induction of labour

2018 ◽  
Vol 7 (5) ◽  
pp. 1730
Author(s):  
Amika Aggarwal ◽  
Sangeeta Pahwa
Keyword(s):  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Induction Of Labor ◽  
Bishop Score ◽  
Uterine Contractions ◽  
Significant Difference ◽  
Misoprostol Group ◽  
Vaginal Misoprostol ◽  
A Prospective Study

Background: The objectives of the current study were to compare the efficacy and safety of 25μg and 50μg of intravaginal misoprostol for induction of labor at term and to study the maternal and fetal outcome.Methods: A Prospective Study was done on 50 cases with 25μg misoprostol and 50 cases of 50μg of misoprostol intravaginal, repeated every 6 hourly till adequate uterine contractions or maximum 5 doses. Total dose of induction, induction delivery interval, mode of delivery, maternal and fetal outcome were recorded.Results: Mean induction delivery interval was 13.8±5.9 and 14.0±5.7 hours (P=0.9) with the 25μg and 50μg misoprostol respectively. The 25μg misoprostol group had a lower delivery rate with a single dose compared with the 50μg group (38% and 42% respectively). However, 25μg group had more deliveries than 50μg group with increasing number of misoprostol doses (36% vs. 38%, and 20% vs. 16% for 2 doses and 3 doses respectively). The need for oxytocin augmentation among participants was higher in the 25μg group (20%) than in 50 μg group (16%).This was however not statistically significant (P=0.603). At lesser initial bishop score, with 50µg misoprostol less doses are needed as compared to 25 µg and hence induction delivery interval decreases. The rates of caesarean section and operative vaginal delivery were similar in both groups. There was no significant difference in maternal side effects and neonatal outcomes among the women in the two groups.Conclusions: The 25 µg of intravaginal misoprostol administered six‑hourly appears to be as effective but safer than 50 µg for induction of labor. The use of 50 µg misoprostol may be recommended when there is a need to expedite vaginal delivery especially in cases of lesser initial bishop score.

Perineal Injury and Its Association with Postpartum Sexual Dysfunction among First Delivery Women

2021 ◽  
Vol 2 (3) ◽  
pp. 34-39
Author(s):  
Z. Nusee ◽  
M. N. Ainy ◽  
P. Hafizah
Keyword(s):  
Sexual Dysfunction ◽  
Vaginal Delivery ◽  
Female Sexual Dysfunction ◽  
Family Income ◽  
Mode Of Delivery ◽  
Sexually Active ◽  
Perineal Tear ◽  
Health Clinics ◽  
Perineal Injury ◽  
Significant Difference

Background: Female sexual dysfunction (FSD) following childbirth imposes significant burden to the marital institution around the world. The perineal injury may potentially be one of the main risk factors contributing to postpartum female sexual dysfunction (PPFSD). The study aimed to determine the effect of perineal injury and patients’ characteristics on PPFSD. Methodology: This cross-sectional questionnaire study was conducted in six different health clinics in the district of Kuantan from April 2019 to October 2019. Eligible women who came to the family health clinics at 6 months postpartum were recruited as study population. The participants completed their biodata and socio-demographic form and the Malay-validated Female Sexual Function Index (MVFSFI) questionnaire given. A cut-off point of 26.55 and below on MVFSFI scoring system was used as a measure of the primary outcome of sexual dysfunction. Results: Out of 240 women who delivered vaginally, 34 (14%) had intact perineum, 107 (44.6%) sustained 1st degree perineal tear, 96 (40%) 2nd degree tear and three (1.25%) 3rd degree tear. Among the respondents, 60.9% of the sexually active respondents who had vaginal delivery, reported to have PPFSD. The timing of sexual resumption does not correlate with the severity of perineal tear. The severity of perineal tear is significantly associated with age (p=0.018), duration of marriage (p=0.008), body mass index (BMI) (p=0.019) and instrumental delivery (p=0.025). The level of personnel skill whom performed the repair were also found to have a significant relationship to PPFSD (p= 0.001). The relationship of participants’ mean age (p=0.271), marriage duration (p=0.903), race (p=0.928), religion (p=0.852), education level (p=0.549), employment status (p=0.102), family income (p=0.460) and BMI(p=0.159) with presence of PPFSD were all found to be statistically not significant. Conclusion: Occurrence of PPFSD is high among sexually active women who had vaginal delivery complicated by perineal tear, especially among those requiring instrumentation. The severity of perineal tear is associated with age, duration of marriage, BMI and mode of delivery. However, PPFSD does not significantly relate to the severity of perineal tear. None of the socio-demographic factors show a significant difference to sexual dysfunction.

scholarly journals Oral Misoprostol vs Intravenous Oxytocin Infusion for Induction of Labor in Prelabor Rupture of Membranes

2016 ◽  
Vol 8 (1) ◽  
pp. 4-7
Author(s):  
Rajyashri Sharma
Keyword(s):  
Side Effects ◽  
Cesarean Delivery ◽  
Fetal Distress ◽  
Induction Of Labor ◽  
Oral Misoprostol ◽  
Oxytocin Infusion ◽  
Misoprostol Group ◽  
The Difference ◽  
Prelabor Rupture Of Membranes ◽  
To Receive

ABSTRACT Objectives To compare the efficacy, side effects and safety of oral misoprostol to intravenous oxytocin infusion for induction of labor in prelabor rupture of membranes (PROM). Materials and methods Two hundred and sixty-six women of prelabor rupture of membranes were assigned to receive either oral misoprostol 100 μg 6 hourly to a maximum 3 doses (misoprostol group, n = 142), or escalating doses of oxytocin infusion up to 20 mIU/min in primigravida and up to 10 mIU/min in multigravida (oxytocin group, n = 114). Results Demographic characteristics were similar in both the groups. The difference in mean induction to delivery interval (8.2 ± 6 hours in misoprostol group vs 12.2 ± 6 hours in oxytocin group) was statistically significant when two groups were compared. The incidence of vaginal delivery (86.1% in misoprostol group vs 84.2% in oxytocin group), and cesarean delivery (13.9% in misoprostol group vs 15.8% in oxytocin group), was almost similar in both the groups. The indication of cesarean delivery was dystocia (40% in misoprostol group vs 67% in oxytocin group), and fetal distress (60% in misoprostol group vs 33% in oxytocin group) and the difference was statistically significant (p < 0.01). Maternal and neonatal safety outcomes were similar for the two treatments. Conclusion Oral misoprostol in prelabor rupture of membrane have almost similar results as intravenous oxytocin in safety, efficacy and side effects except induction delivery interval, which is less in misoprostol group. How to cite this article Anjum S, Sharma R. Oral Misoprostol vs Intravenous Oxytocin Infusion for Induction of Labor in Prelabor Rupture of Membranes. J South Asian Feder Obst Gynae 2016;8(1):4-7.

scholarly journals Amniotic fluid index versus maximum vertical pocket measurement in predicting perinatal outcome at 40 weeks or beyond

2018 ◽  
Vol 7 (12) ◽  
pp. 4887
Author(s):  
Nasreen Noor ◽  
Seema Amjad Raza ◽  
Shazia Parveen ◽  
Mohammad Khalid ◽  
Syed Manazir Ali
Keyword(s):  
Amniotic Fluid ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Prospective Observational Study ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Amniotic Fluid Index ◽  
Institutional Ethics ◽  
Significant Difference ◽  
Baseline Demographic

Background: The aim of this study is to compare the use of amniotic fluid index with maximum vertical pocket for predicting perinatal outcomes.Methods: The present study was a prospective observational study and includes 140 The study include normal antenatal women at gestational age 40 weeks or beyond (by last menstrual period/1st trimester scan) referred from antenatal between 20 to 40 years were enrolled in this study from 2015 to 2017. After Institutional Ethics Committee approval all recruited women was assessed at the 3rd trimester visit for baseline demographic and obstetric data. After taking a detailed history and examination the women were subjected to ultrasonography for Amniotic Fluid index (AFI) and Maximum vertical pocket (MVP). The women were divided into 2 groups based on measurement of AFI and MVP ultrasonologically. The correlation of Amniotic fluid index and Maximum vertical pocket with perinatal outcome were computed for the 2 groups: Group Ia - women having normal AFI and normal MVP; Group Ib - women having decreased AFI and normal MVP.Results: In Group Ia, 31(34.44%) women were induced and in Group Ib 59 (65.56%) women were induced for oligohydramnios. 65 women (72.22%) had normal vaginal delivery versus 25women (27.28%) had undergone LSCS in Group Ia, while in Group Ib, 32 women (64%) versus 18 women (36%) had vaginal delivery and LSCS respectively. Higher rate of LSCS was observed in Group Ib. There was no significant difference in the rate of LSCS for fetal distress between Group Ia and Ib for fetal distress.Conclusions: Amniotic fluid index (AFI) compared with the maximum vertical pocket (MVP) excessively characterizes patients as having oligohydramnios, leading to an increase in obstetric interventions, without any documented improvement in perinatal morbidity and mortality. Thus, authors cannot find any objective reason to favour AFI over MVP.

scholarly journals Mifepristone versus intracervical prostaglandin E2 gel for cervical ripening in primigravid patients at term

2018 ◽  
Vol 7 (3) ◽  
pp. 824 ◽  
Author(s):  
Manoj Kumar Sah ◽  
Saraswati M. Padhye
Keyword(s):  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Human Reproduction ◽  
Cervical Ripening ◽  
Birth Canal ◽  
Significant Difference ◽  
Group A ◽  
Pass Through ◽  
Group B

Background: The cervix has to play dual role in human reproduction. During pregnancy, it should remain firm and closed allowing the fetus to grow in utero until functional maturity is attained while during labour it should soften and dilate, allowing the fetus to pass through the birth canal. Objective of present study was to know and compare the effect of oral Mifepristone with intracervical dinoprostone gel for cervical priming prior to induction of labour at term in an unfavorable cervix of primigravida.Methods: This was prospective randomized comparative study. 100 primigravid patients were included, 50 were placed in each group A and B. Tablet Mifepristone 200mg orally was given in group A patients and intracervical dinoprostone gel induction was done in group B patients. Pre induction Bishop’s score was noted at beginning to compare improvement in Bishop’s score after induction. Mode of delivery and induction to delivery interval in both the groups were studied.Results: After induction with Mifepristone 76% women had successful cervical ripening as compared to 56% with dinoprostone. Rate of vaginal delivery was 70% with Mifepristone and 58% with dinoprostone. There was no significant difference in induction to delivery interval between the groups. Ten percent and 2% belonging to mifepristone and dinoprostone group respectively, required NICU admissions.Conclusions: Mifepristone is more effective than dinoprostone for preinduction cervical ripening as it has high success rate of achieving cervical ripening, however there is no significant difference in the vaginal delivery rate and other maternal and fetal outcome.

Cesarean delivery may increase the risk of multiple sclerosis

2011 ◽  
Vol 18 (4) ◽  
pp. 468-471 ◽  
Author(s):  
Amir-Hadi Maghzi ◽  
Masoud Etemadifar ◽  
Kiyan Heshmat-Ghahdarijani ◽  
Safieh Nonahal ◽  
Alireza Minagar ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cesarean Section ◽  
Birth Order ◽  
Vaginal Delivery ◽  
Conditional Logistic Regression ◽  
Mode Of Delivery ◽  
Age At Onset ◽  
Significant Risk ◽  
Significant Difference ◽  
Healthy Siblings

Background: Prenatal and perinatal factors are believed to contribute to the risk of developing multiple sclerosis (MS). Objective: This study was designed to evaluate whether mode of delivery (vaginal versus cesarean section), as a perinatal factor, affects susceptibility to MS. Methods: MS patients were recruited from the MS registry of Isfahan Multiple Sclerosis Society (IMSS) and were compared with their healthy siblings. Data regarding mode of delivery, birth order, and gestation week of birth were obtained through a specially designed questionnaire. Preterm or post term deliveries were excluded. We used conditional logistic regression statistics and adjusted for gender and birth order. Results: This study included 1349 participants (449 MS patients and 900 controls). Subjects who were born by cesarean section had significant risk of MS (odds ratio, OR = 2.51; 95% confidence interval, CI: 1.43–4.41; p = 0.001). There was significant MS risk for females who were born by cesarean section (OR = 2.69, 95% CI: 1.30–5.58; p = 0.008), but not for males (OR = 2.25, 95% CI: 0.90–5.63; p = 0.082). The mean age at onset was lower in MS patients born by cesarean section (24.58 ± 6.33) compared with that of patients born by vaginal delivery (27.59 ± 7.97; p = 0.041). There was no significant difference between the two groups for birth order ( p = 0.417). Conclusion: Our results suggest that those born by vaginal delivery are at a lower risk of subsequent MS. These preliminary findings will need to be addressed in a much larger and preferably prospective study.

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 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 Oral: Vaginal Misoprostol: Which route for induction of term labor?

1970 ◽  
Vol 2 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Ratna Khatri (Adhikari) ◽  
Jyoti Sharma ◽  
Archana Amatya
Keyword(s):  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Labour Induction ◽  
Active Stage ◽  
Singleton Pregnancy ◽  
Oral Misoprostol ◽  
Significant Difference ◽  
Vaginal Misoprostol ◽  
Failed Induction ◽  
Group B

Aim: To compare the effectiveness of oral misoprostol with vaginal misoprostol for induction of labour at or more than 40 weeks of pregnancy. Method: Study design: Prospective comparative study. Duration: March 2005 to February 2006 (12 months)in the Dept of Obs/Gyn, TU Teaching Hospital, Kathmandu. Methods: Hundred nullipara (primi or gravida 2 with 1 spontaneous or induced abortion < 12 gestational weeks) in a singleton pregnancy > 40 but with Bishop's score < 4 were induced equally with either oral (100 mgm) Group A or vaginal (25mcg) Group B: were administered 4 hourly up to maximum of 6 doses. Primary outcome measures: duration of induction to active stage of labour or delivery, spontaneous rupture of membrane (SROM), meconium stained liquor (MSL), caesarean and neonatal morbidity with respect to Apgar score were assessed. Results: In vaginal 33 oral 17 had SROM with higher incidence of MSL (60% versus 12%) and higher caesarean 15%: 4%. Even there was > fetal distress 11/15: 2/7 group B/, which was statistically significant. No significant difference was noted in the pre induction cervical score, number of doses, induction to active stage of labour, induction to delivery time, use of oxytocin, failed induction and Apgar scores. Conclusion: Oral misoprostol found to be associated with less SROM, meconium stained liquor and vaginal birth and comparatively less neonatal care unit admissions outweighs its advantages over the vaginal misopristol, although either route were equally proven to be effective for inducing labour in women with unfavourable cervix (Bishop's score < 4) at term pregnancy.   doi:10.3126/njog.v2i1.1472 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 23 - 28 May -June 2007

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