scholarly journals INDUCTION OF LABOUR;

2017 ◽  
Vol 24 (04) ◽  
pp. 522-525
Author(s):  
Nadia Taj ◽  
Rahat Akhtar ◽  
Sumera Mehnaz ◽  
Aamir Furqan
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Expectant Management ◽  
Induction Of Labour ◽  
P Value ◽  
Pregnancy Induced Hypertension ◽  
Induction Group ◽  
Induced Hypertension ◽  
Group A ◽  
Group B

Objectives: To compare maternal outcome in planned induction of laborversus expectant management in pregnancy induced hypertension between 36 to 40 weeks ofgestation. Study Design: Randomized controlled trial. Setting: Obstetrics and Gynecology UnitII of Nishter Hospital Multan. Period: January 2016 to July 2016. Materials and Methods: Onehundred and thirty six (136) women with diagnosis of mild pregnancy induced hypertension,having gestational age 36 to 40 weeks were selected for this study. The selected patients wereallocated randomly into two equal groups i.e. Group A (Induction group) & Group B (Expectantgroup). The primary outcomes of this study were rate of cesarean section delivery anddevelopment of severe pre-eclampsia. Independent sample t-test was used to compare agebetween the groups. Chi-square test was used to compare age groups and study endpointsbetween the groups. Results: Mean gestational age at the time of delivery was 38.3 ± 0.75weeks for group A and 39.2 ± 0.55 weeks for group B (P-value >0.05). Mode of delivery was 52(76.47%) patients by vaginal and 16 (23.53%) by caesarean section in group A. While in groupB, out of 68 deliveries, 40 (58.82%) patients delivered by vaginal and 28 (41.18%) by caesareansection (p-value <0.05). Regarding maternal outcomes, severe pre-eclampsia occurred in 05(7.35%) women of group A while in group B, it was noted 15 (22.05%) women (p-value<0.05).The final outcome was considered satisfactory in 76.47% patients in Induction group regardingvaginal delivery and severe pre-eclampsia while in Expectant group satisfactory outcomes wereachieved in only 23.53% women (p-value <0.05). Conclusion: Induction of labour is associatedwith improved maternal outcome in terms of caesarean section and pre-eclampsia in womenwith mild PIH beyond 36 weeks of gestation as compared to the expectant management.

scholarly journals A comparative study of induction of preterm vaginal delivery at 20 to 28 weeks gestation in previous one lower segment caesarean section by foley catheter and prostaglandin E2 gel

2017 ◽  
Vol 6 (8) ◽  
pp. 3581
Author(s):  
Shruti Agarwal ◽  
Neelam Bharadwaj ◽  
Lata Rajoria ◽  
Indira Lamba
Keyword(s):  
Caesarean Section ◽  
Prostaglandin E2 ◽  
Foley Catheter ◽  
Induction Of Labour ◽  
P Value ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Catheter Group ◽  
Group A ◽  
Group B

Background: The aim of the study to assess the maternal outcome and safety of induced preterm vaginal birth after a previous one lower segment caesarean delivery.Methods: In this study, 100 women who had singleton pregnancies with a previous one term lower segment caesarean section, in whom induction of labour was required in between 20 to 28 wks of gestation, were included. Group A (n= 50) were induced by transcervical foley catheter and group B (n= 50) were induced by prostaglandin E2 gel and then progression of labour was monitored. Both groups were compared in terms of induction delivery interval, efficacy and safety.Results: In our study, all women were delivered vaginally and hysterotomy was not required. The mean induction delivery interval in Foley catheter group (20.180±3.3499 hrs) was significantly shorter (p-value <0.001) than PGE2 gel group B (24.050±3.6537 hrs). There was no case of uterine rupture, puerperal pyrexia, postpartum haemorrhage and uterine hyperstimulation.Conclusions: Women with previous lower segment caesarean section in whom premature induction of labour is required for any reason can be done easily, safely and effectively without maternal morbidity. Induction can be done more effectively by using transcervical foley catheter than intracervical prostaglandin E2 gel. It has shorter induction delivery interval and low complication. Hence, I suggest that every woman with previous one lower segment caesarean section who requires premature induction should go for trial of labour before repeating caesarean section.

scholarly journals Maternal Outcomes of Expectant Management In comparison with Induction of Labour within twenty four hours of Premature Rupture of Membranes (PROM).

2020 ◽  
Vol 27 (08) ◽  
pp. 1565-1569
Author(s):  
Saima Ashraf ◽  
Hajira Sultana ◽  
Saima Yasmin Qadir ◽  
Muhammad Khalid
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Expectant Management ◽  
Induction Of Labour ◽  
Maternal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Group A ◽  
Group B

Objective: this study is conducted to compare the maternal outcomes of expectant management versus induction of labour within 24 hours of premature rupture of membranes. Study Design: Randomized controlled trial. Setting: Obstetrics and Gynaecology Department, Nishtar Hospital, Multan. Period: From 15 March 2018 to 15 September 2018. Material & Methods: A total of 130 pregnant women with parity 0 – 4 having singleton pregnancy, ≥37 weeks pregnant and having premature rupture of membranes were taken in the study. Women having previous caesarean section, with history of hypertension or diabetes, features suggestive of chorioamnionitis, preterm pre-labour rupture of membranes and women with foetal distress were excluded from the study. Two groups were made. In Group (A) women were subjected to expectant management in which patients were observed for uterine contractions for a period of 24 hours. In Group (B) women were induced with tab dinoprostone 2 doses each 3 mg given 6 hours apart. Information regarding caesarean section, vaginal delivery and chorioamnionitis was recorded on a specially designed proforma. Results: In this study age range was from 18 to 35 years while in both groups most patients were 28 – 35 years old. In Group (A) mean gestational age was 38.246 ± 0.84 weeks while in Group (B) it was 37.953 ± 0.95 weeks. In Group (A) mean parity was 1.076 ± 1.16 and in Group (B) it was 1.815 ± 1.16. in Group (A) 2.092 ± 0.67 hours was mean duration of PROM while in Group (B) it was 2.092 ±0.67 hours. Mean BMI in Group (A) was 26.088 ±3.80 kg/m2 and in Group (B) it was 26.361 ±4.33 kg/m2. In Group (A), 24 patient (36.9%) delivered vaginally while 42 (64.6%) patient delivered vaginally in Group (B). 41 patients (63%) had cesarean section in Group (A) while in Group (B) 23 patients (35.4%) had cesarean section. Chorioamnionitis was seen in 14 patients (21.5%) in Group (A) while 3 patients (4.6%) had chorioamnionitis in Group (B). Conclusion: Our study concluded that induction of labour with twenty four hours of premature rupture of membranes does causes a reduction in occurrence of chorioamnionitis. By this approach patients are usually delivered within 24 hours and caesarean section rate is not increased. This approach also causes a reduction in augmentation of labour by oxytocin.

scholarly journals Comparison between methyldopa and combination of methyldopa and nifedipine in terms of mean change in blood pressure in pregnancy induced hypertension

2021 ◽  
Vol 15 (7) ◽  
pp. 1703-1705
Author(s):  
Bilqees Akhtar Malik ◽  
Shahzad Bashir Momina ◽  
Tazeen Ashraf
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Gestational Age ◽  
Low Dose ◽  
High Dose ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
Group A ◽  
Group B ◽  
In Pregnancy

Objective: Comparison between Methyldopa and combination of Methyldopa and Nifedipine in terms of mean change in blood pressure in pregnancy induced hypertension. Material and methods: This randomized controlled trial was conducted at Department of Obstetrics and Gynecology, Combined Military Hospital Bahawalpur from February 2020 to August 2020 over the period of 6 months. Total 80 patients with pregnancy induced hypertension as per operational definition having age 20-40 years and having gestational age ≥ 20 weeks assessed on LMP were selected. Results: Mean age of the patients was 30.81 ± 5.670 years, mean age of patients of group A was 31.50 ± 5.809 years and mean age of group B was 30.13 ± 5.515 years. Mean gestational age was 30.17 ± 5.981 weeks, mean gestational age of patients of group A was 29.70 ± 6.329 weeks and mean gestational age of patients of group B was 30.65 ± 5.65 weeks. In group A, mean diastolic blood pressure was decrease from 101.2250 ± 4.97938 to 84.5000 ± 3.26599 and in group B from 107.7750 ± 7.18434 to 82.5000 ± 2.25320. Comparison of mean decrease in diastolic blood pressure between group A (High dose Methyldopa) and group B (Low dose Low dose Methyldopa with Nifedipine) was done. Mean decrease in diastolic blood pressure in group A was 16.72 ± 3.935 and in group B was 25.28 ± 6.876. Statistically significant difference of mean decrease in diastolic blood pressure between the both groups was noted with p value 0.000. Conclusion: Results of this study showed that Low dose Methyldopa with Nifedipine combination is more effective as compared to High dose Methyldopa to reduce diastolic blood pressure in pregnant women suffering from pregnancy induced hypertension. Keywords: Diastolic blood pressure, Methyldopa, Nifedipine, Pregnancy induced hypertension, Systolic blood pressure

scholarly journals Induction of labor versus expectant management of patients with gestational hypertension at term.

2021 ◽  
Vol 29 (01) ◽  
pp. 57-61
Author(s):  
Fozia Mohammad Bakhsh ◽  
Khanda Gul ◽  
Safia Bibi ◽  
Palwasha Gul
Keyword(s):  
Blood Pressure ◽  
Caesarean Section ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Gestational Hypertension ◽  
Expectant Management ◽  
Severe Preeclampsia ◽  
Induction Of Labour ◽  
Group A ◽  
Group B

Objective: To compare maternal morbidity in planned induction of labour versus expectant management in women with gestational hypertension at term. Study Design: Randomized Clinical Trial. Setting: Department of Obstetrics and Gynecology, Bolan Medical Complex Hospital Quetta. Period: January 2017 to December 2017. Material & Methods: 240 pregnant women with the diagnosis of gestational hypertension with systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg without proteinuria were included. Patients were equally divided into two groups; group A (the intervention group) and group B (the expectant group). In group A, cervical ripening was stimulated with use of intravaginal prostaglandins. In group B, patients were monitored until the onset of spontaneous Labour. In both groups intervention was recommended in case of non-optimal FHR, the diastolic blood pressure ≥110mmHg or the systolic blood pressure ≥170 mmHg and eclampsia. Results: Out of 120 deliveries, 87 (72.5%) delivered by vaginal and 33 (27.5%) by caesarean section in group A. While in group B, out of 120 deliveries, 66 (55%) delivered by vaginal and 54 (45%) by caesarean section. The frequency of maternal outcome like mild preeclampsia present in 15% and 40% of women in group A and in group B respectively. Severe preeclampsia was noted 7.5% and 22.5% in group A and in group B respectively. Seizures were found in 2.5% of women in group A and 10% of women in group B. Conclusion: Complications like mild and severe preeclampsia and eclampsia could be prevented by induction of labour at term and also by widespread use of prenatal care education, prompt diagnosis and treatment of gestational hypertension.

scholarly journals TO DETERMINE EFFICACY OF GRANISETRON VERSUS PLACEBO FOR REDUCING SHIVERING IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION UNDER SPINAL ANAESTHESIA

2021 ◽  
Vol 71 (2) ◽  
pp. 530-34
Author(s):  
Sana Abbas ◽  
Bilal Yasin ◽  
Basit Mehmood Khan ◽  
Umer Hayat ◽  
Beenish Abbas ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Elective Caesarean Section ◽  
Patient Comfort ◽  
Military Hospital ◽  
P Value ◽  
Intravenous Bolus ◽  
Lower Segment ◽  
Group A ◽  
Group B

Objective: To determine the efficacy of granisetron versus placebo (saline) for reducing shivering in patients undergoing lower segment caeserian section under spinal anaesthesia. Study Design: Comparative cross - sectional study. Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital Rawalpindi, from Apr to Sep 2019. Methodology: Total 178 patients undergoing lower segment ceaserian section under spinal anaesthesia with age ranges from 18-40 years of American Society of Anaesthesiologists status I & II with full term pregnancy scheduled for elective caesarean section under spinal anaesthesia. Group A (n=92) received an intravenous bolus of 1 mg granisetron in a 10ml syringe and Group B (n=86) received intravenous bolus of normal saline in a 10ml syringe, drugs were administered immediately before spinal anaesthesia by anaesthetist as coded syringes. Heart rate, blood pressure, core body temperature and shivering scores were measured at 0 minutes, 30 minutes and 60 minutes, average surgery time recorded to be 60 minutes. Results: None of the patients in group A (drug group) exhibited appreciable post spinal shivering whereas 25 (29%) in group B (placebo) had clinically significant shivering necessitated administration of other established pharmacological agents to abort shivering in order to ensure patient comfort and satisfaction with statistically significant p-value of <0.05. Conclusion: Prophylactic injection granisetron was efficacious against post spinal shivering, moreover provides worth while relief of nausea and vomiting which is dilemma with most of the drugs employed for control of post spinal shivering.

scholarly journals Single vs Multiple Antibiotic Drug Regimen in Preventing Infectious Morbidity in Caesarean Section: A Randomised Clinical Trial

2021 ◽  
Author(s):  
Subhashchandra R Mudanur ◽  
Shreedevi S Kori ◽  
Aruna Biradar ◽  
Rajasri G Yaliwal ◽  
Dayanand S Biradar ◽  
...  
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Multiple Dose ◽  
Caesarean Delivery ◽  
Surgical Site Infections ◽  
Cost Effective ◽  
P Value ◽  
Infectious Morbidity ◽  
Group A ◽  
Group B

Introduction: Surgical site infections are a serious cause of maternal morbidity and mortality. Various preventive measures are being used to reduce the incidence of surgical site infections. One of them is the use of prophylactic antibiotics. In this study, authors have evaluated three antibiotic regimen with respect to preventing infectious morbidity in caesarean section. Aim: To study the efficacy and cost-effectiveness of a single dose (ceftriaxone) versus multiple doses of antibiotic therapy (ceftriaxone and ornidazole) administered preoperatively in women undergoing caesarean delivery. Materials and Methods: A prospective interventional study was conducted on 300 pregnant women undergoing emergency or elective caesarean delivery. Study was conducted at BLDE (DU) Shri BM Patil Medical College and Research Centre, Vijayapur, Karnataka, India. Patients were randomly assigned to three groups by block random sampling with 100 women in each group. Group A received Inj. ceftriaxone 1 gm single dose 60 minutes prior to commencement of surgery. Group B received Inj. ceftriaxone 1 gm along with Inj. ornidazole 500 mg intravenous infusion 60 minutes prior to commencement of surgery and Group C received Inj. ceftriaxone 1 gm and Inj. ornidazole 500 mg intravenous infusion 60 minutes prior to commencement of surgery and a repeat dose 12th hourly for 24 hours followed by Tab. cefixime 200 mg and Tab. ornidazole 500 mg twice daily for four days postoperatively. The effectiveness of therapy was measured in terms of adverse effects of antibiotics such as nausea and vomiting and postoperative complications like pyrexia, foul smelling lochia, surgical site infections, uterine tenderness, peritonitis and endometritis. Results: There was no statistical difference in outcome measures in side-effects of antibiotics (p-value=0.13), fever (p-value=0.68), lochia discharge (p-value=0.88), wound infection (p-value=0.39) and peritonitis (p-value=0.30) among the three groups. The single dose medication in group A had a cost of Rs.60 INR (0.82 cents USD), which was significantly less compared to the multiple dose regimens in group B that cost Rs.203 INR ($2.76 USD). The mean hospital stay in non infectious and infectious patients were 5 and 10 days in present study (p<0.0001). Conclusion: Caesarean delivery poses 5-20 times greater risk of postoperative infection when compared to vaginal birth. There has been a shifting trend of increasing caesarean deliveries and postoperative infections can contribute to overwhelming health and economic burden. Present study shows outcome measures which were statistically insignificant among the three study groups with different prophylactic regimen for caesarean delivery, so it’s safe to state that both single dose and multiple dose regimen provided equal protective coverage in reducing maternal infectious morbidity. Also, single dose regimen proved to be cost-effective. So, to conclude single dose prophylactic antibiotic given preoperatively in caesarean section is both cost-effective and as is efficient.

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 comparative study of feto-maternal outcome in expectant management versus active management in pre-labor rupture of membranes at term

2017 ◽  
Vol 7 (1) ◽  
pp. 146
Author(s):  
Savitha T. S. ◽  
Pruthvi S. ◽  
Sudha C. P. ◽  
Vikram S. Nadig
Keyword(s):  
Caesarean Section ◽  
Maternal Morbidity ◽  
Caesarean Section Rate ◽  
Mode Of Delivery ◽  
Expectant Management ◽  
Neonatal Morbidity ◽  
Neonatal Infection ◽  
Induction Of Labour ◽  
Active Management ◽  
Induction Group

Background: Premature rupture of the membranes at term is spontaneous rupture of the membranes after 37 weeks of gestation and before the onset of the regular painful uterine contractions, complicates 5-10% of pregnancies, 80% of cases of PROM occur at term. It complicates the pregnancy leading to maternal and fetal complications, immediate risks such as cord prolapse, cord compression and placental abruptions, and later risks such as maternal or neonatal infection and the interventions such as caesarean section and instrumental vaginal delivery. These cases are either managed conservatively or by immediate induction of labour. Objective of present study is to compare the efficacy and safety of induction of labor versus expectant management at term PROM, in terms of maternal and fetal outcome.Methods: A randomized control trial of 100 women coming to KIMSH from 01 /04 /2015 to 01 /05 /2016 with PROM at term with duration of leak ≤6 hours and a Bishop score ≤5 were assigned to group A immediate induction group and group B expectant management group with 50 cases in each group.Results: The mean interval from PROM to delivery was significantly shorter in the induction Group 15.62±4.97 as compared with expectant group 17.58±4.78. Incidence of maternal morbidity and neonatal morbidity was comparable in both the groups. Intrapartum complications and mode of delivery were similar in both groups.Conclusions: Immediate induction of labour in cases of PROM at term using oral misoprostol resulted in shorter induction delivery interval and hospital stay. Maternal morbidity and neonatal morbidity was comparable in both groups. It is concluded that immediate induction is better than expectant management. With active management many patients delivered vaginally within 24 hours without increase in the Caesarean section rate and decreased the need for oxytocin augmentation.

scholarly journals Comparative Study on Planned repeat Caesarean Section and Unplanned Repeat Caesarean Section

2016 ◽  
Vol 24 (1) ◽  
pp. 57-61
Author(s):  
Jinnatun Nur ◽  
Rashida Khanom ◽  
Sumaya Akter
Keyword(s):  
Caesarean Section ◽  
Subsequent Pregnancy ◽  
T Test ◽  
P Value ◽  
Retrospective Case ◽  
College Hospital ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
First Time

Repeat Caesarean section always carries more risk than first time caesarian delivery. In our country, antenatal care is always neglected. When this negligence occurs during subsequent pregnancy who had already goes on Caesarean section for the first pregnancy. In our study, we try to compare between the planned and unplanned repeat Caesarean section. The study was carried out at Mymensingh Medical College Hospital, Mymensingh and Amina Nursing Home at Charpara Mymensingh. This was a retrospective case control study, There were 100 patients in Group: A, (Planned repeat Caesarean section), Group B was also consisted with 100 patients (Unplanned repeat Caesarean section). Odd ratio was measured. Odd ratio between group; A and Group: B was 2.8. The two groups were compared by their age and independent t test was carried out. Group: A. Mean ± SD 25.76 ± 4.461Group: B. Mean ± SD = 26.12 ± 5.513. By pair independent t test: P value: .076ns. So we can conclude that regular antenatal Check up is mandatory for those whose 1st delivery was conducted by Caesarean section irrespective of age and economical status.J Dhaka Medical College, Vol. 24, No.1, April, 2015, Page 57-61

scholarly journals Neurodevelopment and growth outcome at one year in babies born at term to mothers having pregnancy induced hypertension

2018 ◽  
Vol 5 (6) ◽  
pp. 2183
Author(s):  
Deepthi Pagali ◽  
Suneetha Bollipo ◽  
Srinivasa Vithal Rao Natta
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Physical Growth ◽  
P Value ◽  
Growth Monitoring ◽  
Hypertensive Disorder ◽  
Pregnancy Induced Hypertension ◽  
Neurodevelopmental Outcomes ◽  
Induced Hypertension ◽  
One Year

Background: Hypertensive disorder in pregnancy remains an important cause of perinatal morbidity and mortality. Being small for gestational age (SGA) may be associated with poor neurodevelopmental outcomes compared to being appropriate for gestational age (AGA). The aim of this paper is to evaluate neurodevelopmental scores as well as growth monitoring in SGA and AGA infants born at term to PIH mothers followed till one year of age.Methods: This is a prospective, observational, hospital-based study, conducted in a tertiary care mother and child institute in Andhra Pradesh, South India.Results: Two hundred babies born at term to PIH mothers are included in the study and are followed up over a period of 12 months. Data is analyzed using Statistical Package for Social Sciences (SPSS). Growth retardation is seen in 12 % of term, SGA and 3.5% of term, AGA babies. SGA babies have a statistically significant correlation (p value = 0.02) in physical growth compared to AGA babies. Neurodevelopmental delay is present in 30% of SGA babies and 5% of AGA babies. The association between SGA and neurodevelopmental disability is statistically significant (p value <0.01).Conclusions: Pregnancy induced hypertension has a statistically significant effect on neurodevelopment and physical growth of a child when followed up to 12 months of age, in SGA babies, more so in VLBW babies. Early intervention programmes through medical, developmental, neuromotor, neurosensory interventions and other stimulation programs, might help in reducing the burden of the disease as well as improving the quality of life. 

Sign in / Sign up

Export Citation Format

Share Document