scholarly journals A Comparative Study of Extra-Amniotic Saline Infusion (EASI), Foley’s Catheter and Prostaglandin E2(PGE2) gel for Pre-Induction Cervical Ripening

2018 ◽  
Vol 1 (2) ◽  
pp. 28-32
Author(s):  
Keshar B. Dhakal ◽  
S. Rai Dhakal
Keyword(s):  
Mode Of Delivery ◽  
Cost Effective ◽  
Saline Infusion ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Delivery Time ◽  
Successful Induction ◽  
The Mean ◽  
Time Changes ◽  
Foley’S Catheter

Introduction: Cervical ripening is essential for successful induction of labor. The aim of the study is to compare the efficacy, safety and cost-effectiveness of extra-amniotic saline infusion, Foley’s catheter and intra-cervical PGE2 gel for pre-induction cervical ripening. Methods: A total 150 women having indications of labor induction were randomly assigned equally into three groups: EASI, Foley’s catheter and PGE2 gel. Eligible full-term pregnancy with Bishop score 4 or less was recruited for the study. Computer generated randomization method and random numbers were used to allocate cases into three groups. Data were analyzed by SPSS. The induction to cervical ripening interval, induction to delivery time, changes in the Bishop Score, mode of delivery and cost were assessed. Results: Majority of the cases was primigravida (67.3%) and the most common indication of induction was postdated pregnancy (72%). The mean time for induction to cervical ripening interval was shorter in Foley’s catheter and EASI than PGE2 (6.92 & 5.69 vs 11.08 (P<0.006). Majority of cases in Foley’s catheter and EASI achieved the Bishop score of 7 or more within 24 hours of induction as compared to PGE2 (88% & 84% vs 54%, P<0.000). The mean induction to delivery time is found shorter in EASI and Foley’s catheter than PGE2 (14.95hrs & 16.84hrs vs 23.18hrs). Conclusions: Foley’s catheter and extra-amniotic saline infusion (EASI) are the most efficacious, cost effective and safe methods of cervical ripening as compared to PGE2 gel.

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 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 Intracervical PGE2 gel application for cervical ripening and induction of labour: a clinical study

2019 ◽  
Vol 8 (9) ◽  
pp. 3528
Author(s):  
Shilpa Modi ◽  
Jayalaxmi Mahur ◽  
Shashank V. S.
Keyword(s):  
Low Dose ◽  
Mode Of Delivery ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Pelvic Examination ◽  
Bishop Score ◽  
Single Application ◽  
Uterine Contractions ◽  
Successful Induction ◽  
Labour Room

Background: PGE2 gel (cerviprime) not only helps in cervical ripening but also sensitizes the uterine musculature to physiological PGE2 for generation and maintenance of uterine contractions. In the present study the efficacy of PGE2 intracerival gel for ripening and induction of labour has been reported.Methods: This is a randomized prospective study of 80 cases admitted to the labour room during period of 2 years i.e. March 2017 to March 2019 in Department of Obstetrics and Gynecology, KBNIMS, Gulbarga, Karnataka. All patients had clear indications for termination of pregnancy. The initial bishop score determined prior to induction by pelvic examination. Under aseptic precautions PGE2 endocervical gel was instilled. The results analyzed for successful ripening, induction delivery interval, results in primigravida and multigravida with single instillation or reinstallation if required, mode of delivery and maternal and perinatal complications.Results: The present study of 80 cases showed that a single application of intracervical PGE2 gel caused favorable changes in cervix by increasing Bishop score and shortened induction delivery interval with minimal side effects. Successful ripening with single application was achieved in 92.5% of cases (primi 42.5% and multi 50%). Only 6.25% of primi's and 1.25% of multi’s required reinstallation of PGE2 gel. Successful induction was achieved in 47.5% primi's and 50% multi’s i.e. 97.5% cases.Conclusions: The study concludes that single low dose intracervical PGE2 (cerviprime) gel proved to a safe, reliable and effective method for cervical ripening and induction of labour.

scholarly journals Comparison of Foley’s catheter with PGE2 gel and Foley’s catheter with PGE2 gel with extra amniotic saline infusion for labour induction

2018 ◽  
Vol 7 (5) ◽  
pp. 1782
Author(s):  
Shobha Bembalgi ◽  
Lavanya . ◽  
Vinutha M. B.
Keyword(s):  
Foley Catheter ◽  
Saline Infusion ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Bishop Score ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
Foley’S Catheter ◽  
Group 1

Background: Induction of labour is initiation of uterine contractions before the onset in order to vaginally deliver the foetoplacental unit. Common reasons for induction of labour are post-term and hypertensive disorders of pregnancy. The purpose of this study was to compare the efficacy of Foley catheter with intra cervical PGE2 gel and Foley catheter with PGE2 gel with extra amniotic saline infusion for induction of labour.Methods: The clinical trial was conducted from November 2016 to April 2017 at Karnataka Institute of Medical Sciences, Hubballi. 80 pregnant women which included both primigravidae and multigravidae were alternatively divided into two groups. Group 1 received Foley’s and PGE2 gel and group 2 received Foley’s, PGE2 gel and extra amniotic saline infusion for induction of labour.Results: Both groups were comparable with respect to maternal age, gestational age and indication for induction. There was no significant difference in the mean pre-induction Bishop score between two groups. In both the groups there was significant improvement in the Bishop score after 6 hours of induction. But progress in group 2 was greater than group 1(P <0.05). The mean time from induction to delivery in group 2 was shorter and was statistically significant(P<0.05). There was no difference in mode of delivery, neonatal and maternal morbidity and mortality between 2 groups.Conclusions: The present study showed that Foley’s with PGE2 gel with extra amniotic saline infusion is better for labour induction though both groups appear to be effective agents.

scholarly journals Induction of labor in women with unfavourable cervix: comparison of efficacy of intracervical Foley catheter with PGE2 gel

2019 ◽  
Vol 8 (6) ◽  
pp. 2178
Author(s):  
Shilpa Gupta ◽  
Bhumika Kagathray
Keyword(s):  
Foley Catheter ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Patient’S Satisfaction ◽  
Unfavourable Cervix ◽  
Successful Induction ◽  
Group A ◽  
Group B

Background: The aim of our study was to compare the efficacy, safety and patient’s satisfaction of intracervical Foley catheter with intracervical dinoprostone gel (PGE2 gel) for cervical ripening for successful induction of labor.Methods: Prospective study was conducted in Department of Obstetrics and Gynaecology, M P Shah Medical College, Jamnagar, Gujarat. 317 women with term pregnancy with bishop score of less than 4 with various indications for induction were included. Intracervical foley catheter was kept in 162 women for cervical ripening (group A) while intracervical PGE2 gel was kept in rest 155 women (group B).  The change in the bishop score, progress of labor, adverse effects and outcome of labor along with the patient’s satisfaction were assessed.Results: With regard to the obstetrical parameters, the two groups were comparable with respect to maternal age, gestational age, parity, indication for induction and initial bishop score. At 12 hours, both the groups showed significant improvement in bishop score, 5.2±1.81 and 4.8±1.76 in Foley catheter and PGE2 gel respectively. Mean induction to delivery interval was 18.8±5.5 in group A and 17.9±5.3 in group B, which was statistically insignificant.  No significant differences in side effects, mode of delivery and APGAR score were noted in both the groups. However, the incidence of hyperstimulation and tachysystole was higher in PGE2 gel group.Conclusions: This study shows that both Foley catheter and dinoprostone gel appear to be equally effective agents for cervical ripening. Infect foley catheter is cheap, causes less fetal distress and is safer than PGE2 gel.

scholarly journals A Randomized Controlled Trial of Extra-amniotic Saline Infusion vs Intracervical Dinoprostone Gel for Induction of Labor

2017 ◽  
Vol 1 (1) ◽  
pp. 11-17
Author(s):  
Steffi V Rodrigues ◽  
MK Swamy ◽  
Namrata Jadhav
Keyword(s):  
Randomized Controlled Trial ◽  
Birth Weight ◽  
Vaginal Delivery ◽  
Controlled Trial ◽  
Induction Of Labor ◽  
Saline Infusion ◽  
Cervical Ripening ◽  
Randomized Controlled ◽  
The Mean ◽  
Foley’S Catheter

ABSTRACT Background Success of induction depends largely on cervical ripening and increases the likelihood of vaginal delivery. This study compared the outcomes for induction of labor using extra-amniotic saline infusion (EASI) vs intracervical dinoprostone gel. Objective: Primary: To compare improvement between pre- and post-induction Bishop’s scores in both the groups. Secondary: To compare induction to delivery interval, mode of delivery, and neonatal outcome in both the groups. Materials and methods A randomized controlled trial of 1 year was conducted in the Department of Obstetrics and Gynaecology, Karnataka Lingayat Education University Dr Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India, on 82 pregnant women from January 2014 to December 2014. The selected women were divided into two groups of 41 each as group I (induced with dinoprostone) and group II (induced with EASI using Foley’s catheter). Results Significantly higher number of women had postinduction Bishop’s scores between 9 and 12 in the dinoprostone group (70.73%; p < 0.001). The mean Bishop’s scores were significantly high in the dinoprostone gel (9.27 ± 3.07) vs EASI (8.22 ± 2.34; p = 0.086). Cervical ripening based on cut-off score of ≥6 was noted in a significantly higher number of women (92.68%) in EASI (p = 0.241). The mean time for cervical ripening was significantly high in dinoprostone gel group compared with EASI (15.44 ± 8.41 vs 3.88 ± 3.67; p < 0.001), but mean induction to delivery time was comparable (p = 0.086). Significantly higher numbers of vaginal deliveries were noted in dinoprostone group (91.43%; p = 0.001). The neonatal outcomes, i.e., birth weight, mean birth weight, appearance, pulse, grimace, activity, and respiration score at 1 and 5 minutes, and neonatal intensive care unit admission, were comparable (p = 0.570). Conclusion Dinoprostone gel and EASI using Foley’s catheter appear to be effective methods for cervical ripening and labor induction, but dinoprostone gel yielded significantly higher rate of vaginal delivery. How to cite this article Rodrigues SV, Swamy MK, Jadhav N. A Randomized Controlled Trial of Extra-amniotic Saline Infusion vs Intracervical Dinoprostone Gel for Induction of Labor. Int J Gynecol Endsc 2017;1(1):11-17

scholarly journals Intra-cervical foley’s catheter or PGE2 gel for induction of labour: which one is better: a prospective study

2021 ◽  
Author(s):  
Khushpreet Kaur ◽  
Balwinder Kaur ◽  
Navneet Kaur ◽  
Gagandeep Kaur
Keyword(s):  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Controlled Study ◽  
Group A ◽  
The Mean ◽  
Foley’S Catheter ◽  
Group B

Background: Labour is clinically defined as the initiation and perpetuation of uterine contraction with goal of producing progressive cervical effacement and dilatation. The Foley’s catheter is an effective alternative to prostaglandins for cervical ripening/labour induction. Study was done to compare the efficacy of intracervical Foley’s catheter and PGE2 gel as a cervical ripening agent and to study maternal and fetal outcome in terms of mode of delivery and Apgar score.Methods: This randomized controlled study was conducted in Obstetrics and Gynaecology department, Government Medical College, Patiala. 200 women with indication for induction of labour were enrolled in the study to investigate the efficacy and fetomaternal outcome of induction of labour with intracervical Foley’s catheter comparing with PGE2 gel.Results: The mean age in group A was 24.41±3.37 and in group B was 24.24±3.17 years. The 95% women were induced successfully in group A and 97% were successfully induced in group B. Preeclampsia and postdatism were the most common indications for induction in both groups. The mean induction delivery interval in group A was 15.20±4.53 hours and in group B was 15.86±4.79 hours. 4.21% cases required NICU admission in group A while in group B, it was 5.15% cases.Conclusions: Our study concludes that there is no difference in efficacy between intracervical Foley’s catheter and intracervical PGE2 gel for induction of labour and both methods are complementary to each other.

scholarly journals Efficacy and Safety of Foley Catheter Balloon for Cervix Priming in Term Pregnancy

2017 ◽  
Vol 30 (4) ◽  
pp. 281 ◽  
Author(s):  
Catarina Policiano ◽  
Mariana Pimenta ◽  
Diana Martins ◽  
Nuno Clode
Keyword(s):  
Foley Catheter ◽  
Mode Of Delivery ◽  
Tertiary Hospital ◽  
Mechanical Effect ◽  
Induction Of Labor ◽  
Catheter Removal ◽  
Bishop Score ◽  
Delivery Time ◽  
Singleton Pregnancy ◽  
Previous Cesarean

Introduction: Foley catheter promotes cervix priming by a direct mechanical effect of distension.Material and Methods: A prospective observational study was conducted at a tertiary hospital, including all cases of induction of labor with Foley catheter between September 1, 2013 and November 30, 2015. Women were eligible if they had a singleton pregnancy with a Bishop score < 6 and a gestational age ≥ 41 weeks or a medical indication for induction of labor. The primary outcome was the Bishop score variation (difference between Bishop score before and after insertion of Foley catheter). Mode of delivery, induction-to-delivery time, uterine tachysystole with fetal decelerations, peripartum fever ≥ 38º C, maternal pain and mortality were also analyzed.Results: Within 201 inductions with Foley catheter, average increase in Bishop score after catheter placement was three (1 - 7), with only 5% (11/201) of unmodified cervix after catheter removal/extrusion. Vaginal delivery rate was 71% (142/201) and in women with a previous cesarean section (n = 40) was 37% (15/40). Average induction-to-delivery time was 38 hours (4 - 120). Uterine infection rate was 3% (6/201). There was only one case of significant vaginal bleeding which required immediate catheter removal. There has been no significative maternal or neonatal morbidity.Discussion/Conclusion: Foley catheter is a safe and effective method of cervical priming for women with an unfavorable cervix, even in the case of a previous cesarean delivery.

scholarly journals Comparative study of misoprostol sublingually and dinoprostone gel intracervically for cervical ripening and induction of labor

2017 ◽  
Vol 6 (8) ◽  
pp. 3624
Author(s):  
Shikha Yadav ◽  
Nootan Chandwaskar
Keyword(s):  
Mode Of Delivery ◽  
Cost Effective ◽  
Active Phase ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Cost Effective Method ◽  
Sublingual Misoprostol ◽  
Misoprostol Group ◽  
Oxytocin Augmentation ◽  
Live Fetus

Background: Both Prostaglandin E1 and E2 analog are being used for cervical ripening. The aims of study was to compare the efficacy and safety profile of sublingual misoprostol (PGE2) and intracervical dinoprostone (PGE1) for cervical ripening and induction of labor.Methods: One hundred women with single live fetus and with gestational age of more than 37 weeks admitted for induction of labor were recruited for the study. Patients were randomized to receive either 25μg of misoprostol sublingually or dinaprostone gel (0.5mg) intracervically.Results: There was shorter induction to active phase, induction to delivery time intervals and less requirement of oxytocin augmentation in misoprostol group than dinoprostone gel group. Incidence of tachysystole was higher in misoprostol group than dinoprostone gel group (22% vs 10%) however this was not statistically significant. Mode of delivery, maternal and neonatal complications were similar in both the groups.Conclusions: Use of misoprostol in lower dose is a safe and cost-effective method for cervical ripening and induction of labor.

scholarly journals Relationship between cervical elastography and spontaneous onset of labor

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yoshie Yo ◽  
Yasushi Kotani ◽  
Reona Shiro ◽  
Kiko Yamamoto ◽  
Risa Fujishima ◽  
...  
Keyword(s):  
Onset Time ◽  
Labor Pain ◽  
Cervical Ripening ◽  
Objective Method ◽  
Bishop Score ◽  
Delivery Time ◽  
Spontaneous Onset

AbstractCervical elastography might be an objective method for evaluating cervical ripening during pregnancy, but its usefulness has not been fully investigated. We examined the significance of cervical elastography in the last trimester of pregnancy. Cervical elastography was performed at weekly checkups after 36 weeks of gestation in 238 cases delivered at our hospital from 2017 to 2018. The correlation with the onset time of natural labor, which is an index for judging maternal delivery preparation status, was examined. A total of 765 examinations were conducted, and cervical stiffness determined by cervical elastography was positively correlated with the Bishop score (r = 0.46, p < 0.0001). When examined separately for each week, only the examinations performed at 39 weeks were associated with the onset of spontaneous labor up to 7 days later (p = 0.0004). Furthermore, when stratified and analyzed by the Bishop score at 39 weeks of gestation, cervical elastography was associated with the occurrence of spontaneous labor pain for up to seven days in the groups with Bishop scores of 3–5 and 6–8 (p = 0.0007 and p = 0.03, respectively). In conclusion, cervical elastography at 39 weeks of pregnancy is useful for judging the delivery time.

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