Intracervical prostaglandin E2, 0-5 mg; gel or tablet for cervical ripening and induction of labour with an unfavourable cervix?

1993 ◽  
Vol 13 (3) ◽  
pp. 167-170 ◽  
Author(s):  
T. Yacoob ◽  
M. Lloyd ◽  
A. Unwin ◽  
R. F. Harrison
Keyword(s):  
Prostaglandin E2 ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Unfavourable Cervix

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 Oral Versus Vaginal Misoprostol for Induction of Labour

1970 ◽  
Vol 24 (2) ◽  
pp. 44-49 ◽  
Author(s):  
N Sultana ◽  
S Rouf ◽  
M Rashid
Keyword(s):  
Pregnant Women ◽  
Mode Of Delivery ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Singleton Pregnancy ◽  
College Hospital ◽  
Nulliparous Women ◽  
Unfavourable Cervix ◽  
Oral Group ◽  
Vaginal Misoprostol

It is sometimes difficult to select the most effective, easy to use, safest, widely accepted and less expensive method for induction of labour and thereby spontaneous vaginal delivery. Prostaglandin E1 analogue ie misoprostol as a successful method both in oral and vaginal form has been used for induction of labour. The present study was conducted with an aim to compare the efficacy and safety of oral and vaginal administration of misoprostol tablets for cervical ripening and induction of labour in pregnant women using similar dosing regimen in two groups of pregnant women. A prospective randomized trial was done on one hundred pregnant women for the purpose. They were between 37 and 42 weeks of gestation with singleton pregnancy, cephalic presentation and unfavourable cervix (modified Bishops score of 4 or less) in the department of Obstetrics and Gynaecology of Dhaka Medical college Hospital during the period between February 2003 and March 2004. The mode of delivery did not vary significantly between the two groups. Mean induction delivery interval, mean doses of misoprostol, number of women delivered within 24 hours, oxytocin requirement and mean time to delivery were nearly similar in the two groups. Only nulliparous women in oral group took longer time to deliver than vaginal group though it was not statistically significant. The mode of delivery also did not differ significantly. The proportion of emergency caesarean section was high in vaginal group than oral group. Neonatal outcome was satisfactory and the results were comparable. (J Bangladesh Coll Phys Surg 2006; 24: 44-49)

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 Oral mifepristone as adjuvant to prostaglandin E2 (PGE2) gel for preinduction cervical ripening and induction of labour in third trimester

2017 ◽  
Vol 6 (9) ◽  
pp. 3952
Author(s):  
Jitendra D. Mane ◽  
Sanjay Singh ◽  
Anil Kumar Singh
Keyword(s):  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Control Group ◽  
Study Group ◽  
Third Trimester ◽  
Safety And Efficacy ◽  
Vaginal Deliveries ◽  
Spontaneous Labour ◽  
Unfavourable Cervix

Background: Whenever the intrauterine milieu is not conducive for the foetus and continuation of pregnancy may affect adversely to mother and the fetus, termination of the pregnancy is planned. Objective of this work was to study the safety and efficacy of oral mifepristone as adjuvant to PGE2 gel in pre-induction cervical ripening and induction of labour in third trimester.Methods: 150 patients in third trimester were recruited in this single blind randomized control trial that were planned for delivery with unfavourable cervix. They were randomly allocated into two groups i.e. study group (n = 75) who received Tab. Mifepristone 200 mg orally and control group (n = 75) who received placebo orally. At the end of 48 hours (h), change in the Bishop’s Score was assessed and those with unfavourable cervix or not in labour, were administered PGE2 gel intracervically every 6h, for maximum of 3 doses for pre-induction cervical ripening of cervix. Analysis regarding safety and efficacy of the drug was done with regards to maternal and perinatal outcome.Results: Out of 150 patients, 75 received mifepristone and 75 received placebo. Mean Bishop’s Score showed significant improvement after 48h in study group (R R 5.135, 95% CI 4.78 to 5.48) compared to control group (RR 3.43, 95% CI 3.21 to 3.65). Significant number of women went in spontaneous labour in study group (39 v/s 20) (p - 0.035) in each dose category of PGE2 application. The opportunity to induce labour (with oxytocin) was better in study group in each dose category of intracervical PGE2 gel application. Moreover, lesser number of PGE2 gel was used in study group comparing control group. However, there were no statistical differences in both the groups as far as number of vaginal deliveries and caesearean sections are concerned. Duration of labour in both the groups was same. Neonatal and maternal morbidity was comparable in both the groups.Conclusions: Mifepristone improves Bishops score when given 48 h prior to labour induction along with increased number of spontaneous labour and reduced need for PGE2 gel applications, without increasing maternal or neonatal morbidity.

scholarly journals COMPARATIVE STUDY BETWEEN FOLEY CATHETER AND DINOPROSTONE GEL FOR CERVICAL RIPENING AND INDUCTION OF LABOUR IN PATIENTS AT TERM WITH UNFAVOURABLE CERVIX (BISHOP'S SCORE<4)

2019 ◽  
pp. 1-4
Author(s):  
Shrikant Warade ◽  
Anshul Pahwa ◽  
Savita Dhongade
Keyword(s):  
Foley Catheter ◽  
Mode Of Delivery ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Time Interval ◽  
Vaginal Deliveries ◽  
Unfavourable Cervix ◽  
Group B ◽  
Singleton Pregnancies

BACKGROUND- Since ancient times, labour inducton is a well established obstetric concept. In the past few decades, rate of labour induction has increased dramatically. The primary objective of this study was to compare the efcacy of transcervical foley catheter with intracervical dinoprostone gel for cervical ripening and labour induction in term singleton pregnancies with unfavourable cervix. METHODS- Term singleton pregnancies fullling inclusion criteria were randomized by chit box system to receive intracervical dinoprostone or transcervical foley catheter. Progress of labour was monitored with the help of partogram. Labour augmentation was done by oxytocin. RESULTS- 110 patients in each group were enrolled. Group A was induced with transcervical Foley catheter and group B with dinoprostone gel. Baseline characteristics like maternal age, parity, gestational age were comparable in each group. There was a signicant difference in the Bishop's score (<.0.05) at the end of 12 hours, Group B showing a greater improvement than A. A signicant difference was also observed in the requirement of augmentation with Pitocin, 77.27% in foley group and 63.63% in dinoprostone group . Although, there was no signicant difference observed in the mode of delivery (p>0.05) and induction to delivery time interval (p>0.05) , maternal and neonatal morbidity between the groups. CONCLUSION- To conclude, Dinoprostone is associated with rapid cervical ripening . Although, mean induction to delivery interval and number of vaginal deliveries were comparable between the groups. Moreover, cost and safety prole of foley catheter makes it comparable or even superior to dinoprostone gel for cervical ripening and induction of labour, especially in developing countries.

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