scholarly journals Mifepristone versus oxytocin for cervical ripening prior to induction of labour

2018 ◽  
Vol 6 (3) ◽  
pp. 90-95
Author(s):  
Rosina Manandhar ◽  
Rachana Saha ◽  
Junu Bajracharya ◽  
Rumina Malla
Keyword(s):  
Controlled Trial ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Good Alternative ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
P Value ◽  
Delivery Mode ◽  
Vaginal Deliveries ◽  
Number Of Patients

Background: Induction of labour is one of the most important interventions done in modern obstetric practice and the success of induction techniques depends upon its role in cervical ripening and improvement in the Bishop’s score.Objectives: This study was done to compare the improvement in Bishop’s score among the women receiving oral mifepristone and oxytocin infusion to ripen the cervix prior to induction of labour at term.Methods: This was a hospital based, prospective randomized controlled trial conducted from August 2015 to February 2016. A total 68 patients were randomized into two groups: Mifepristone group and Oxytocin group. The improvement in Bishop’s score prior to and after 48 hours of cervical ripening, induction to delivery interval in vaginal delivery, mode of delivery, any adverse maternal and foetal outcome were recorded in both the groups.Results: The study demonstrated an overall significant improvement in Bishop’s score in mifepristone group compared to oxytocin group (p-value=0.003). A significant number of patients in mifepristone group had improved mean Bishop’s score (p-value=0.001) after 48 hours of cervical ripening. There were more vaginal deliveries in the mifepristone group, with shorter mean induction to delivery interval as compared to the oxytocin group. There were no maternal side effects and adverse perinatal outcomes in both the groups.Conclusions: Mifepristone is a good alternative to oxytocin for cervical ripening for induction of labour.

scholarly journals A study of effect of oral PGE1 and cervical PGE2 on induction of labor and mode of delivery

2018 ◽  
Vol 7 (6) ◽  
pp. 2160
Author(s):  
Sukanya Mukherjee ◽  
H. Valson ◽  
Balaji K.
Keyword(s):  
Mode Of Delivery ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
P Value ◽  
Singleton Pregnancy ◽  
Outcome Indicators ◽  
Oral Misoprostol ◽  
Vaginal Deliveries ◽  
Group A ◽  
Group B

Background: Induction of labor is one of the most important procedures done by the Obstetricians. Induction of labor with the help of prostaglandins offer the advantage of promoting cervical ripening along with stimulating the contractility of the myometrium.Methods: 200 pregnant women with singleton pregnancy both nulliparous and multiparous, were included in the study at term gestation (>39weeks) with Bishop’s score <6, and reactive NST. The subjects were divided in to two groups Group A including patients who were given oral PGE1 - 50 mcg Tab, and Group B with cervical PGE2, 0.5 mg, gel. The outcome indicators were recorded in both Group A and Group B and analyzed. The mean time taken from induction to vaginal delivery in Group A was 628±67 minutes and in Group B was 839±118 minutes. Incidence of LSCS in Group B when compared to Group A (p value <0.005).Results: Incidence of LSCS in Primi’s in Group B compared to Primi’s in Group A was statistically significant (p value 0.009). Non-progression of labor was observed to be the major indication for LSCS in Group B. Meconium stained labor was found to be the major indication for LSCS in Group A.Conclusions: The study concludes that using 50 mcg oral misoprostol, is an effective and safe mode of induction of labor in comparison to PGE2 gel. Vaginal deliveries are more with the use of oral misoprostol and the induction to delivery interval is also lesser than that in cervical PGE2 use.

scholarly journals INDUCTION OF LABOR;

2017 ◽  
Vol 24 (02) ◽  
pp. 288-292
Author(s):  
Raheela Baloch ◽  
Nigar Jabeen ◽  
Sana Zahiruddin ◽  
Ms. Kiran Mawani
Keyword(s):  
Side Effects ◽  
Prostaglandin E2 ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Bishop Score ◽  
Efficacy And Safety ◽  
Vaginal Deliveries ◽  
Number Of Patients

Efficacy and safety of intra-vaginal prostaglandin E2 pessary for induction ofLabor. Objectives: To evaluate the efficacy and safety of intra-vaginal prostaglandin E2 pessaryfor induction of Labor. Study Design: Case control study. Setting: Gynecological and obstetricward of Liaquat University of Medical and Health Sciences Hospital, Hyderabad. Period: 14 Feb2012 to 13 Feb 2013. Study Population: All the Pregnant women at term or post term admittedin gynae ward from 14th February 2012 to 13th February 2013. Results: 100 women recruitedin the study, study carried out at Gynecological ward of Liaquat University of Medical and HealthSciences Hospital Hyderabad. Analysis of booking status listed in Table-I revealed that 68% (n= 68) were un-booked having no antenatal care and 32.0% (n = 32) were booked. There wereno protocol violation, relation to the parity listed in Table-II showed maximum number of patients(n = 62) 62.0% Primigravida and (n = 38) 38.0% multigravidas were include. Age distributionis listed in Table-III maximum patients (n = 49) 49.0% at age between 26 - 35 years, 35 (35.0%)were between 20 - 25 years, 10 (10.0%) were >35 years and 06 (6.0%) patients were belong toless than 20 years. Regarding the gestational age 57 (57.0%) patients in our study presentedbetween 37 - 39 weeks of gestation. However, 47 (47.0%) patients were at 40 - >40 weeksof gestation showed in the (Table-IV). Indication for cervical ripening and induction of laboris listed on Table-V commonest indication was pregnancy induced hypertension followed byprolonged pregnancy, and IUGR etc. Table-VI shows the Bishop score 30 (30.0%) had BishopScore 2 – 3, while 70(70.00%) had a bishop score 4-5. Table-VII shows induction-deliveryinterval, Greater number of women (66/100) delivered within 24 hours of start of induction.Table-VIII showed mode of delivery, majority of the women had normal vaginal deliveries 64.00while 16 deliveries by assisted vaginal deliveries while in remaining 20 cases caesarean sectiondone. Table-IX shows four babies had an Apgar score 4/10 at end of 1 min and 7/10 at end of5 min, whereas 96 babies had an Apgar score of 9/10 in 1 min. The indications for caesareansection are shown in Table-X. There were 09(9%) cases of failed induction, 11 cases of a fetaldistress (Meconium stained liquor). There was no increased incidence of neonatal sepsis orChorioamniotis or puerperal sepsis in any of our patients. No perinatal morbidity or mortalityor any severe maternal complications were noted while mild side effects were noted which ismentioned in (Table-XI). Conclusion: In developed countries prostaglandin E2 are widely usedfor ripening of unfavorable cervix in induction of labor but patient response vomiting, diarrhea,tachycardia, and fever are commonly observed minor side effects. Induction with Prostaglandinreduced the rate of pregnancies progressing beyond 41 weeks and related feto-maternalmorbidity and mortality. After excluding contra indication all women should be offered inductionat 41 completed weeks. Induction with prostaglandin with medical disorder like preeclampsia issafe and better feto maternal outcome.

scholarly journals Efficacy and safety of oral mifepristone for cervical priming and induction of labor in term pregnancy

2018 ◽  
Vol 7 (7) ◽  
pp. 2766 ◽  
Author(s):  
Abhilasha Gupta ◽  
Aruna Verma ◽  
Iti Madan ◽  
Monika Kashyap
Keyword(s):  
Controlled Trial ◽  
Group Versus ◽  
Perinatal Outcomes ◽  
Active Phase ◽  
Cervical Ripening ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Bishop Score ◽  
Term Pregnancy

Background: The objectives of the study was to assess the efficacy of mifepristone in priming the cervix/inducing labor over next 96 hrs in term pregnancy.Methods: In this single blind randomized controlled trial 200 women with term pregnancy beyond 39 weeks and Bishop’ score <6 were randomly allocated into two groups. Tab Mifepristone 400 mg orally was given to women in study group (n=100) and no intervention in control group (n=100). On follow up one case was lost in control group. All women were observed for change in the bishop’s score or onset of labor in next 96 hrs. If Bishop’s score was <6, the choice of induction was left on the clinician/patient.Results: Mean induction to delivery interval, duration of active phase and improved Bishop score were 79.35±53.43 hr, 2.47±1.23 hr, 6.68±1.69 for study group versus 148±65.66 hr, 3.09±1.45 hr, 5.8±2.15  for control group (p value is <0.001) respectively.  Seventy one (71%) women in study group and 39 (39.3%) women in control group delivered vaginally within 96 hrs without any need of augmentation. There were 9 (9%) caesareans in study group and 24 (24.2%) caesareans in control group but no instrumental delivery in both groups. There was no statistically difference in perinatal outcomes between two groups.Conclusions: Mifepristone is an effective drug for cervical ripening and initiation of labor when given in term pregnancy beyond 39 weeks with poor Bishop’s score (<6) and appearing to reduce need for other agent for augmentation of labor.

scholarly journals A randomised controlled trial of preinduction cervical ripening-dinoprostone versus foleys catheter

2017 ◽  
Vol 6 (6) ◽  
pp. 2387
Author(s):  
Mumtaj M. ◽  
Harilakshmi M.
Keyword(s):  
Controlled Trial ◽  
Mode Of Delivery ◽  
Cost Effective ◽  
Fetal Outcome ◽  
Cervical Ripening ◽  
Maternal Complications ◽  
Number Of Patients ◽  
Significant Difference ◽  
Failed Induction ◽  
Randomised Controlled

Background: Cervical ripening before induction of labour in women with unfavourable cervix is essential to shorten the induction to delivery interval and avoid unnecessary interventions.Methods: The study was carried out at Raja Sir Ramasamy Mudaliar hospital, Chennai during the period August 2012 to July 2013. 200 antenatal women were recruited and randomly allocated to Foleys and prostaglandin E2 gel group for induction. The change in bishops score, induction to delivery interval, mode of delivery, vaginal delivery within 24 hours, maternal complications, fetal outcome between both groups were compared.Results: The commonest indication for induction in both groups was postdated pregnancy followed by oligohydramnios in Foleys group and preeclampsia in PGE2 group. Foleys catheter induction improves bishops score better compared to PGE2 gel whereas PGE2 gel causes a significant reduction in the mean induction to delivery interval between the two groups. However, there was no significant difference between mean caesarean deliveries between the two groups. In both Foleys and the PGE2 group, failed induction was the commonest indication for caesarean section. The number of patients delivering vaginally within 24 hrs was similar between the two groups.Conclusions: Though prostaglandins are a better method of induction, this study shows that Foleys induction has reduced side effects and is also cost effective, making it a superior method for cervical ripening.

scholarly journals The Role of Low Dose Misoprostol in Cervical Ripening and Induction of Labour Beyond the Age of Viability and its Effects on Maternal and Fetal Outcomes

JMS SKIMS ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 18-21
Author(s):  
Humaira Ali ◽  
Cimona Lyn Saldanha ◽  
Tabasum Parveiz ◽  
Rabia Khurshid
Keyword(s):  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
P Value ◽  
Delivery Time ◽  
Fetal Outcomes ◽  
Group I ◽  
Number Of Patients ◽  
Group Ii ◽  
Vaginal Misoprostol

This study was conducted to compare the efficacy and safety of oral (50 μg) and vaginal (25 μg) misoprostol for cervical ripening and induction of labour. Two hundred patients with indications for labour induction randomly received either 50 μg oral misoprostol every 4 h (Group-I) or 25 μg vaginal misoprostol every 4 h (Group-II), for maximum of six doses. Mean induction to delivery time, delivery within 24 hrs, mode of delivery, oxytocin use, number of doses used, failed induction rate and maternal complication and fetal outcomes were compared for the two groups. Mean induction delivery time was significantly longer in Group-I (20.55±5.59 hrs) than in Group-II (16.70±7.12 hrs) (with mean difference of 3.85 and P-value of <0.001). Mean number of doses of misoprostol used for oral and vaginal misoprostol study populations were 2.61±0.94 and2.37±1.20respectively. Oxytocin augmentation was required in significantly more number of patients in oral group (80%) than in vaginal group (68%) with P-value of 0.027. There were 3 failed inductions in the oral and 4 in the vaginal group after a total of six doses of misoprostol. Incidence of maternal and fetal complications was similar between two groups. Our findings indicated that, 25μg vaginal misoprostol has the potential to induce labor as safely as, and more effectively than, 50 μg oral analogue. JMS 2017; 20(1):18-21

scholarly journals Maternal and Fetal Outcomes of Adolescent Pregnancies at Patan Hospital

2016 ◽  
Vol 11 (1) ◽  
pp. 11-13
Author(s):  
Laxmi RC ◽  
Reetu Baral ◽  
R Shrestha ◽  
P Gurung ◽  
S Lama
Keyword(s):  
Birth Weight ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
P Value ◽  
Delivery Mode ◽  
Age Group ◽  
Premature Rupture ◽  
Maternal Complications ◽  
Adult Age

Aims: This study aims to review obstetric and neonatal outcome and risk factors in adolescent pregnant women and to compare perinatal outcomes with the adult group.Methods: This is a retrospective comparative study in between primiparous pregnant teenager women aged 15-19 years and   20-24 years from April 2012 to April 2013 in Patan Hospital Lalitpur, Nepal. The data was retrieved from the hospital records. Frequency of prenatal care, perinatal outcome (newborn’s weight and gestational age at delivery), mode of delivery and maternal complications if any were recorded.  Results: Neonates with normal birth weight (>2.5-4 kg) was seen in 70% (n=248) of the adolescent age group and 85% (n=1797) of adult age group. Neonates with low birth weight (<2.5 kg) was significantly higher in the adolescent age group with 29% (n=102) than the adult age group with only 13% (n=287). The occurrence of premature rupture of membrane and preterm premature rupture of membrane also show statistically significant association (Chi-square test p-value 0.000) on mother’s age having 18% and 2% respectively in adolescent pregnancy.Conclusions: There was significant association of neonatal complications like still birth, fetal distress, and meconium aspiration with the adolescent pregnancy. There was no significant association between neonatal death and age of mother. 

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.

COMPARISON OF SAFETY AND EFFICACY OF INTRACERVICAL DINOPROSTONE GEL AND EXTRA-AMNIOTIC FOLEY'S CATHETER FOR INDUCTION OF LABOUR

2021 ◽  
pp. 13-15
Author(s):  
Radha Garg ◽  
Bharti Saxena ◽  
Neha Dhingra ◽  
Madhu Meena
Keyword(s):  
Mode Of Delivery ◽  
Full Term ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Vaginal Deliveries ◽  
Before And After ◽  
The Difference ◽  
Foley’S Catheter ◽  
Group B

BACKGROUND: The uterus remains quiescent throughout 9 months and begins to act on its own when full term is approached. Almost 50% women deliver in the duration of one week before and after the calculated EDD; and induction of labour is needed in about 20% of women: to increase the success of labour induction, to reduce the duration and complications of labour and to diminish the rate of caesarean sections. Cervical ripening is needed before induction of labour. There are many methods for induction of labour; however till date, none of them can claimed to be the best. To compare the AIM OF PRESENT STUDY: safety and efcacy of Dinoprostone gel versus intracervical foley's catheter for ripening of cervix and induction of labour. Compara MATERIAL AND METHODS: tive prospective study was conducted on 400 full term uncomplicated primigravida women needing induction of labour between January 2019 to June 2020 in department of obstetrics & gynecology at GMC Kota in Rajasthan.Group A: 200 women induced with Dinoprostone gel and Group B: 200 women induced with extra-amniotic Foley's catheter. Baseline characteristics like maternal age, gestational age, indication for induction were comparable in both the groups. The mean induction to delivery interval was shorter in RESULT: group A (12.69 ± 3.64 hours) as compared to Group B (18.17 ± 3.17 hours) and this difference was statistically highly signicant (P = 0.0001). There was no signicant difference observed in mode of delivery, labour progress at 18 hours, indication for caesarean section, maternal side effects, mean birth weight, Apgar score at 5 mins, number of NICU admissions between the two groups. The number of vaginal deliveries we CONCLUSION: re similar in both the groups but mean induction to delivery interval was signicantly shorter with Dinoprostone gel. However, the maternal and fetal outcomes were better in Foley's catheter group although the difference was not statistically signicant

scholarly journals Comparative study of induction of labour with dinoprostone gel versus mechanical dilatation in unfavorable cervix (low Bishops Score)

2017 ◽  
Vol 6 (10) ◽  
pp. 4363 ◽  
Author(s):  
Gayatri Mathuriya ◽  
Sharad Pratap Singh Kushwaha ◽  
Shweta Pradhan
Keyword(s):  
Vaginal Delivery ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
P Value ◽  
Common Procedure ◽  
Vaginal Deliveries ◽  
Group A ◽  
The Mean ◽  
Mean Time

Background: Induction of labour is a common procedure in obstetrics, occurring in upto 30% of pregnancies. Objective of present study was to compare the efficacy of double balloon transcervical catheter to that of a PG vaginal insert among women undergoing labour induction in terms of singleton pregnancies of both nulliparous and multiparous women with an unfavorable cervix.Methods: Patient admitted for induction of labour were randomized to receive intravaginal dinoprostone or intracervical Foley’s catheter. Patient not entering active labour and having rupture membranes or arrest of dilatation received IV oxytocin.Results: 150 patients received dinoprostone gel (group A) and 150 patients received Foleys catheter no.18 (group B). The mean time until cervix ripening was less in group A group (0.0001-p value). The mean time until vaginal delivery was less in the Group A group (p value-0.010) among vaginal deliveries more patients in the Group A group delivered within 24 hours (0.0001-P value.). There was significant differences in cesarean delivery rates (8% vs 20.66%, P value-0.0001, sig). Oxytocins is required in both groups (73.33% vs. 78.66%).Conclusions: Group A was associated with more rapid cervical ripening, shorten induction to vaginal delivery interval and greater no. of vaginal deliveries within 24 hours.

scholarly journals Oral misoprostol solution in comparison to vaginal misoprostol for induction of labour in a randomized controlled trial

2020 ◽  
Vol 9 (9) ◽  
pp. 3530
Author(s):  
Ahmed M. Abbas ◽  
Peter R. Thabet ◽  
Amgad E. Abour Gamrah ◽  
Osama S. El-Kady
Keyword(s):  
Controlled Trial ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Controlled Clinical Trial ◽  
P Value ◽  
Randomized Controlled ◽  
Group I ◽  
Oral Misoprostol ◽  
Vaginal Misoprostol

Background: With more than 15% of all gravid women requiring prostaglandins in cervical ripening and labour induction. However, evidence is not clear about the preferred route or dose of the drug. So, this study was designed with objectives to compare the induction delivery interval and safety of titrated oral misoprostol solution with vaginal misoprostol for labour induction in term primigravida women.Methods: This randomized controlled clinical trial was conducted on a total of 100 patients randomly selected among primigravida at term women undergoing induction of labour for obstetric or medical indication for labour induction in Ain Shams University Maternity Hospital. They were divided into two Groups: Group I: patients undergoing induction of labour using misoprostol oral solution and Group II: patients undergoing induction of labour using vaginal misoprostol.Results: Oral misoprostol solution has less induction delivery duration and less side effects than vaginal misoprostol. The induction-delivery time with the oral route compared to the vaginal one (15.2 versus 20.3 hours respectively) with significant p-value (<0.001).Conclusions: Titrated oral misoprostol is safe and effective for labour induction in primigravida patients with unfavorable cervix.

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