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 A COMPARITIVE STUDY ON INDUCTION OF LABOUR VERSUS EXPECTANT MANAGEMENT IN TERM PREMATURE RUPTURE OF MEMBRANES IN TERTIARY CARE HOSPITAL ,VISAKHAPATNAM

2019 ◽  
pp. 1-3
Author(s):  
Kavitha Gayak
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Expectant Management ◽  
Induction Of Labour ◽  
Care Hospital ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Management Group ◽  
Group A ◽  
Group B

Premature rupture of membranes (PROM), also called Prelabour Rupture Of Membranes, is classically dened as rupture of membranes before labour and accounts for 0.8-0.9% of all pregnancies at term. this study was conducted over a period of 14 months ( from March 2018 to May 2019) in a tertiary care medical college . A total of 100 term PROM patients were recruited in our study – and divided into two groups randomly--50 (Group A) patients were managed conservatively and 50 (Group- B) patients underwent induction of labour. Both these patient groups were studied to compare the feto-maternal outcome. Group-A (conservative management group) patients were observed to await the spontaneous onset of labour pains for at least 24 hours. Patients in group B were induced with either - PGE1 tab (misoprostol) 25 µgm 4 hourly orally or iv oxytocin infusion. the PROM-delivery interval was < 12 hours in 72 % of induced groups (Group B) and 10% (5) in group- A (conservative or expectant group). LSCS rate was 10 % in group-A (expectant group) & 15 % in group –B (induced group). Sepsis rate, maternal and fetal, hospital stay, NICU admission & duration of NICU stay were notably higher in group – A (expectant management group). therefore, from our study we concluded that immediate induction of labour in term PROM cases shortens the PROM- delivery interval, hospital stay, NICU stay and reduction in both maternal & neonatal sepsis

scholarly journals Comparison of Blood Loss in Manual and Spontaneous Removal of Placenta in Caesarean Section

2020 ◽  
pp. 80-84
Author(s):  
Sabeen Ashraf ◽  
Azra Saeed Awan ◽  
Hina Tabassum ◽  
Omair Ashraf ◽  
Touseef Fatima ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Analysis Data ◽  
Research Committee ◽  
Chi Square ◽  
Chi Square Test ◽  
Group A ◽  
Group B

Background: Efforts should be made to minimize the blood loss at the time of cesarean section. The techniques used to reduce the blood loss include finger splitting versus scissor cutting of incision, in situ stitching versus exteriorization and stitching of uterus and finally spontaneous or manual removal of the placenta. Objective: The main objective of this study is to correlate the frequency of loss of blood between the placenta removed manually and spontaneously during cesarean section. Methods: Randomized controlled trial in the department of Obstetrics and Gynecology, Fauji Foundation Hospital, Rawalpindi. The sample is collected through Consecutive (non- probability) sampling. The study was conducted after approval from the hospital ethical and research committee. Informed written consent was taken from all the patients. The patients were divided into two groups, group A and group B randomly by using random table numbers. Group A had spontaneous placental delivery. Group B had manual placental delivery. Each patient was examined thoroughly and detailed history was taken. Data Analysis: Data was analyzed using SPSS 20 for windows. The frequency and percentage of blood loss were measured. A chi-square test was applied to correlate the blood loss between the two groups. p values <0.05 were considered statistically significant. Effect modifiers like age, gestational age, parity were controlled by stratification. Results: The blood loss was compared between both groups using the chi-square test not assuming null-hypothesis. The blood loss was comparatively high in-group in which the placenta was removed manually (p=0.007). Keywords: Caesarean Section, Placenta removal, Spontaneous, Manual, Blood loss.

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 Obstetric and perinatal outcomes of expectant management and immediate induction of labour in term premature rupture of membranes: promising outcomes from expectant management cohort

2022 ◽  
Author(s):  
Sunil E. Tambvekar ◽  
Shobha N. Gudi
Keyword(s):  
Caesarean Section Rate ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Fetal Outcome ◽  
P Value ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Chi Square ◽  
Group A ◽  
Group B

Background: Premature rupture of membranes (PROM) is common obstetric entity, the management even at term is controversial and there is no consensus for definite protocol of management. Objective of the present study is to compare the effectiveness, safety of expectant management of 24 hours and immediate induction with PGE2 gel in terms of maternal and fetal outcome in term PROM.Methods: 200 women were randomized to group A expectant management and group B immediate induction, after strict Inclusion and exclusion criteria. In expectant group waiting period was 24 hours. Multiple end points were examined throughout management. Chi square test and independent t tests were performed for statistical analysis. P value<0.05 was considered significant.Results: Demographic parameters of patients, maternal and gestational age were similar in both groups. Primigravidae were more in both groups A and B. Vaginal delivery rate is more in expectant group and Caesarean Section rate is high in immediate induction group. CS rate was 37% and 23% in group A and B respectively; the difference is statistically significant (p value=0.031). ‘ROM to delivery interval’ was more in group A (16.31±8.67 hrs and 13.85±5.46 hrs) (p value=0.0256). Hospital stay was comparatively more in group A (5.40±0.81 days and 4.11±0.86 days) (p value=0.435). Infective morbidity of mother and baby was low in both groups and no difference was seen.Conclusions: An expectant management allows a good number of women to go into labour and deliver vaginally without an increase in CS rate and infectious morbidity for mother and fetus.

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.

Fetal and Maternal Outcome Asymptomatic vs. Symptomatic Covid Positive Pregnant Women

2021 ◽  
Vol 15 (10) ◽  
pp. 3423-3425
Author(s):  
Amna Najam ◽  
Samreen Fakeer Muhammad ◽  
Samia Saifullah ◽  
Maryam Shoaib ◽  
Maria Anwar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Apgar Score ◽  
Adverse Outcomes ◽  
Maternal Outcomes ◽  
Group A ◽  
Nicu Admission ◽  
Group B

Objective: The aim of this study is to compare the fetal and maternal outcomes in between asymptomatic and symptomatic COVID positive pregnant women. Study Design: Retrospective cohort study Place and Duration: The study was conducted at Gynae and Obs department of Sandeman Provincial Hospital, Quetta for duration of six months from November 2020 to April 2021. Methods: One hundred and ten pregnant women with ages 18-45 years had corona virus disease were presented. Informed written consent was taken from all patients for detailed demographics. COVID -19 was diagnosed by PCR. 55 patients had symptoms of coronavirus were included in group A and 55 patients did not show symptoms were included in group B. Frequency of pre-eclampsia, gestational diabetes mellitus and post-partum haemorrhage were calculated. Maternal adverse outcomes (cesarean section, instrumental delivery, induction of labor and prolong labor, hypertensive disorder) were calculated among both groups. Fetal outcomes perinatal mortality, Low birth weight, Low Apgar score and NICU admission were observed. SPSS 20.0 version was used to analyze all data. Results: Mean age of the patients in group A was 28.47±3.18 years with mean BMI 24.03±5.24 Kg/m2 and in group B mean age was 27.99±4.17 years with mean BMI 24.44±6.41 Kg/m2. Maternal outcomes (cesarean section, instrumental delivery, induction of labor and prolong labor,) in symptomatic group were significantly higher than that of asymptomatic group. Fetal outcomes, perinatal mortality in group A 9 (16.4%) and in group B was 5 (9.1%), low birth weight in group A was among 21 (38.2%) and in group B was 10 (18.2%), low apgar score in group A was 11 (20%) and in group B was 8 (14.4%), 15 (27.3%) in group A went to NICU admission and 3 (5.5%) patient in group II admitted to NICU. Conclusion: In this study we concluded that adverse outcomes among symptomatic COVID pregnant women were higher than that of asymptomatic coronavirus pregnant women in terms maternal and perinatal outcomes. Keywords: Pregnant women, Coronavirus, Symptomatic, Asymptomatic, Adverse Outcomes

scholarly journals Oral and vaginal route of misoprostol for induction of labour: a comparative study

2019 ◽  
Vol 8 (5) ◽  
pp. 1956
Author(s):  
Deepti D. Sharma ◽  
Kavita A. Chandnani
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Induction Of Labour ◽  
Vaginal Route ◽  
Oral Misoprostol ◽  
Group A ◽  
The Mean ◽  
Vaginal Misoprostol ◽  
Group B ◽  
To Receive

Background: Induction of labour can be defined as “Artificial initiation of uterine contractions before the onset of spontaneous labour, after the period of viability, by any methods, for purpose of vaginal delivery.” The key factor for a successful induction is the status of cervix, its form, consistency and dilatation which is determined by the Bishop score. In case of unfavourable cervix or in the pregnancies remote from the term; prostaglandins are more effective than any other method of induction. Introduction of misoprostol, PGE1 analogue, for the induction of labour in 1993 and its approval for clinical use by ACOG (American College of Obstetrics and Gynecology) in 1999 has been the most significant advancement. It is the latest drug for induction of labour which is cheap and stable at room temperature and is being used worldwide in different doses and by various routes. We compared the most commonly preferred two routes; vaginal and oral in terms of success of induction and noted the adverse events and side effects in both routes.Methods: This was a prospective comparative study carried out at SBKSMIRC (Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre), Dhiraj general hospital, Vadodara, Gujarat, 200 patients who required induction of labour were recruited after applying inclusion and exclusion criteria and were randomly divided in two groups- Group A meant to receive 50µg oral misoprostol, Group B - meant to receive 25µg vaginal misoprostol repeated 4 hourly up to maximum of five doses. Progress of labour was charted on the partograph. The mean induction delivery interval, mode of delivery, maternal and neonatal outcomes and complications were observed.Results: The mean induction to delivery interval was significantly less in vaginal group than oral (23.3±12.4 hours in oral vs. 17.3±10 hours in vaginal). Vaginal delivery and cesarean section rates were comparable in both groups (76% in Group A vs. 72% in Group B for vaginal delivery, 18% vs. 20% for Cesarean section, respectively). 58% patients in Group A required more than two doses as compared to 39% in group B, though the difference was statistically not significant. Significant number of patients required added oxytocin administration in Group A (72%). No major complications or adverse events were observed. Neonatal hyperbilirubinemia was seen more in Group A.Conclusions: Both Oral misoprostol in a dose of 50μg and vaginal misoprostol 25 μg every four hours, to a maximum of five doses, have the potential to induce labour safely and effectively. The vaginal route however is beneficial in effecting delivery in lesser time with few numbers of doses as compared to oral route.

TO COMPARE THE FETOMATERNAL OUTCOME OF ORAL MISOPROSTOL SOLUTION AND VAGINAL MISOPROSTOL TABLET FOR INDUCTION OF LABOUR AT TERM IN THE DEPARTMENT OF OBSTETRICS & GYNAECOLOGY, SMS MEDICAL COLLEGE, JAIPUR

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Neelam Bhardwaj ◽  
Parveen . ◽  
Prerna . ◽  
Neeta Meena ◽  
Prem .
Keyword(s):  
Controlled Trial ◽  
Meconium Aspiration Syndrome ◽  
Induction Of Labour ◽  
Medical College ◽  
Oral Misoprostol ◽  
Misoprostol Group ◽  
Group A ◽  
Nicu Admission ◽  
Vaginal Misoprostol ◽  
Group B

Background: Induction of labour is a common intervention, required in situations where continuation of pregnancy may be lifethreatening for the mother and/or fetus. In industrialized countries, the induction rate ranges from 10-25%. Methods: Randomized controlled trial was conducted at Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. Results: APGAR score at 1 min and 5 minutes was 6.64 and 6.84 in oral misoprostol and vaginal misoprostol group respectively, while at 5 minutes it is 6.7 oral group and 7 of vaginal misoprostol group. 34% of cases need NICU admission in Group-A (Oral misoprostol) and 14% in Group-B (Vaginal misoprostol) group. Meconium aspiration syndrome which is present 10% of patients in Group-A (Oral Misoprostol) while it is present in 6% of patients in Group-B (Vaginal misoprostol). Conclusion: The lesser incidence of meconium-stained liquor and NICU admissions and fewer caesareans with better neonatal outcome in women induced with oral misoprostol outweigh its advantages over the vaginal misoprostol Keywords: Misoprostol, Labor, Induction, Fetomaternal outcome.

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