scholarly journals Efficacy and Safety of Sublingual versus Vaginal Misoprostol for Pre-induction Cervical Ripening among Primigravida

2018 ◽  
Vol 17 (1) ◽  
pp. 18-24
Author(s):  
Indira Acharya ◽  
Sumana Thapa ◽  
Pushpa Chaudhary

Introduction: Induction of labor is an intervention intended to artificially initiate uterine contractions resulting in progressive effacement and dilatation of the cervix. This is a common intervention during pregnancy in both industrialized and non-industrialized countries.Misoprostol is the commonly used induction agent. The objective of this study was to compare the efficacy of sublingual route of misoprostol with that of vaginal for pre-induction cervical ripening at term among Primigravida.Methods: This study was a hospital based cross sectional comparative study, conducted at a tertiary center, Kathmandu over a period of 6 months extending from July 2010 to December 2010. Primigravida at 40-42 weeks of gestation who met the inclusion criteria were enrolled in this study and were randomly enrolled for sublingual misoprostol and vaginal misoprostol.Results: More women in the vaginal misoprostol group had Bishop score more than six after 8 hours of insertion of first dose (80%) compared to those who received sublingual misoprostol (48%). The mean induction to   delivery interval was shorter in the vaginal misoprostol group (12.12 hours) compared to (12.96) in sublingual group. Use of oxytocin for augmentation of labour was required more in the sublingual group but the difference was not significant statistically.Conclusion: Both sublingual and vaginal routes of misoprostol administration were equally effective and appeared safe for pre-induction cervical ripening at term. 

2018 ◽  
Vol 17 (2) ◽  
pp. 18
Author(s):  
Indira Acharya ◽  
Sumana Thapa ◽  
Pushpa Chaudhary

<p><strong>Introduction: </strong>Induction of labor is an intervention intended to artificially initiate uterine contractions resulting in progressive effacement and dilatation of the cervix. This is a common intervention during pregnancy in both industrialized and non-industrialized countries.Misoprostol is the commonly used induction agent. The objective of this study was to compare the efficacy of sublingual route of misoprostol with that of vaginal for pre-induction cervical ripening at term among Primigravida.</p><p><strong>Methods:</strong> This study was a hospital based cross sectional comparative study, conducted at a tertiary center, Kathmandu over a period of 6 months extending from July 2010 to December 2010. Primigravida at 40-42 weeks of gestation who met the inclusion criteria were enrolled in this study and were randomly enrolled for sublingual misoprostol and vaginal misoprostol.</p><p><strong>Results: </strong>More women in the vaginal misoprostol group had Bishop score more than six after 8 hours of insertion of first dose (80%) compared to those who received sublingual misoprostol (48%). The mean induction to   delivery interval was shorter in the vaginal misoprostol group (12.12 hours) compared to (12.96) in sublingual group. Use of oxytocin for augmentation of labour was required more in the sublingual group but the difference was not significant statistically.</p><p><strong>Conclusion: </strong>Both sublingual and vaginal routes of misoprostol administration were equally effective and appeared safe for pre-induction cervical ripening at term. </p>


Author(s):  
Bina M. Raval ◽  
Nainesh S. Zalavadiya ◽  
Pushpa A. Yadava ◽  
Shital T. Mehta

Background: Labour is a final consequence of Pregnancy and is inevitable. The timing of labour may vary widely but it will happen sooner or later. The aim of the present research was to study the safety, efficacy and effect of intra vaginal Misoprostol and intra cervical Dinoprostone gel for induction of labour.Methods: 100 patients who required labour of induction were included in this prospective cross-sectional study from September 2017- March 2018. 50 patients of them received 25mcg tablet misoprostol intravaginal and 50 patients of them required 0.5mg intracervical dinoprostone gel and doses were repeated every 6 hourly for up to maximum 6 doses for Misoprostol and 3 doses for Dinoprostone gel.Results: The majority of patients had gestational age above 40 weeks and between 37-40 weeks in PGE2 and PGE1 group respectively. The mean time taken for the onset of labour was less in Misoprostol than in Dinoprostone group (43.22min v/s 1 hr40 min). The mean time taken for induction to active phase of labour (1hr 42min v/s 4hr 10min) and active phase to delivery (3hr 6min v/s 4hr54min) was less in Misoprostol than Dinoprostone group. The mean time required for induction to delivery was less in Misoprostol group (5hr 2min v/s 11hrs). Requirement of oxytocin for augmentation of labour was almost equal in both groups. Caesarean section rate was less in Misoprostol group (10% v/s 22%). Maternal side effects were minimal in either groups and neonatal outcome was good in both the groups.Conclusions: Both Misoprostol and Dinoprostone gel are safe, effective for cervical ripening and induction but Misoprostol is more cost effective and stable at room temperature.


2018 ◽  
Vol 13 (3) ◽  
pp. 51-55
Author(s):  
Sailaja Ghimire ◽  
Deepanjali Sharma ◽  
Samjhana Dhakal ◽  
Gehanath Baral

Aims: To compare the outcome and side effects of administration of sublingual misoprostol with vaginal misoprostol for induction of labour and cervical ripening. Methods: It was a hospital based comparative study which was carried out in 120 patients in each group of sublingual and vaginal route of misoprostol induction from August 2016 to February 2017 at Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu. Patients with Bishops score <6 were subjected for Misoprostol 25 μg (for maximum 2 doses) 6 hours apart. Results were analyzed using SPSS 21 taking p-value <0.05 as statistically significant. Results: The mean change in Bishops score after 6 hours of misoprostol was statistically signifi cantly (p=0.001) in sublingual group in comparison to vaginal group. The diff erence in augmentation rate was not statistically signifi cant (p= 0.811). The mean time interval from drug administration to delivery was almost similar in both groups. The indications for cesarean section were similar in both the groups, the most common being fetal distress, (67.33% in sublingual and 58.065% in vaginal group). In terms of maternal and neonatal outcome there was no difference. Conclusions: Sublingual route results in significant changes of Bishop’s score as compared to vaginal route. It was also significantly better in terms of fetal outcome. However, both routes appeared similar in terms of maternal outcome.


Author(s):  
. Kalpana ◽  
Priya Sharma ◽  
Amit Kaushik ◽  
Priyanka Rao ◽  
Neelam Swaroop ◽  
...  

Background: The aim of this study was to compare the low dose of vaginal misoprostol and dinoprostone gel for the induction of labour at term of pregnancy.Methods: The study was conducted on 90 women, randomized into two groups, each group having 45 women. First group received misoprostol per vaginally and second group received the dinoprostone gel. The duration of induction to delivery interval, mode of delivery and complications related to labour or foetus were recorded.Results: The mean induction to delivery interval in the misoprostol group was 11.68 ± 4.49 hours and in the dioprostone gel group was 14.85 ± 7.08 hours. Applying the modified t-test, this difference is statistically significant (P value 0.004). Thus misoprostol leads to early labour and early delivery as compared to dinoprostone gel.Conclusions: As shown in this study, vaginal misoprostol is highly effective induction agent with no adverse effect on the outcome of labour as compared to dinoprostone gel.


KYAMC Journal ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 668-672 ◽  
Author(s):  
Sohana Siddique ◽  
Muhammad Jahangir Howlader ◽  
Joysree Saha ◽  
Kazi Shahnaz Begum

Objective: To compare efficacy and safety of oral misoprostol over vaginal misoprostol for labour induction.Materials and Methods: This is a cross sectional interventional hospital based comparative study which was carried in the department of Obstetrics and Gynecology in DMCH from 01.07.2008 to 31.12.2008.Results: Almost equal number of patients delivered vaginally spontaneously in both group, there is no association between route of administration and mode of delivery. Nausea,vomiting occurred more in oral group and uterine hypertonicity more in vaginal group.Conclusion: In this study, 50 patients were randomly selected for oral group and 50 patients for vaginal group. There were no significant differences regarding age, duration of pregnancy, Bishop's score and indication of induction of labour.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 668-672


2020 ◽  
Vol 7 (6) ◽  
pp. 997
Author(s):  
Dharmendra Jhavar ◽  
Neha Kirti ◽  
Sumit Kumar Vishwakarma ◽  
Umesh Kumar Chandra ◽  
Vinod Verma

Background: Since a long time ago, the experts have realized that determination of cut-off point for diagnosing diabetes will be revised over time with the lower blood glucose level as the more sensitive diagnosis for detecting the occurring complication and biochemical changes.Methods: This cross sectional study was carried out in the department of medicine, M.G.M. Medical College and M.Y. Hospital Indore from July, 2016 to August, 2017 in 200 individuals and patients having euglycemic status attending General Medicine OPD.Results: In the low and high normal group 2 (2.0%) and 8 (8.0%) were having abnormal total cholesterol (TC) level respectively. The mean total cholesterol in the low normal group was 117.16±26.94mg/dl and it was 154.74±28.38mg/dl in the high normal group. The difference was found to be statistically significant (p value 0.000). In the low and high normal group, 4 (4.0%) and 17 (17.0%) were having abnormal triglyceride (TG) levels respectively. The mean TG levels in the low and high normal group were 96.93±22.64mg/dl and 110.55±32.37mg/dl respectively. The difference was found to be statistically significant (p value 0.001). In the low and high normal group, 6 (6.0%) and 14 (14.0%) patient was having abnormal uric acid levels respectively. The mean uric acid levels in the low and high normal group was 4.88±1.10mg/dl and 5.31±1.31mg/dl respectively. The difference was found to be statistically significant (p value 0.013).Conclusions: Higher levels of Cholesterol and Triglycerides were found more commonly in high normal euglycemic group compared to low normal euglycemic group. Mean cholesterol and mean triglyceride levels were higher in high normal euglycemic group.


Author(s):  
Shikha Yadav ◽  
Nootan Chandwaskar

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.


2021 ◽  
Vol 8 (12) ◽  
pp. 1799
Author(s):  
Momammed Mustafizur Rahman ◽  
Shabnam Imam ◽  
Sayedatun Nessa ◽  
A. K. M. Maruf Raza ◽  
Farida Arjuman ◽  
...  

Background: This cross- sectional observational study was carried out with an aim to look for microsatellite instability (MSI) status in colorectal carcinoma and their association with different histomorphological patterns and biological behavior of colorectal carcinoma.Methods: This cross-sectional observational study was done in the Department of Pathology, Bangabandhu Sheikh Mujib Medical University Hospital (BSMMU), Dhaka, Bangladesh during September 2014 to October 2015. A total of 39 surgically resected sample of colorectal carcinoma were included. Consent from each patient was taken. The samples were histopathologically evaluated according to the standard protocol. The statistical analyses were done using Statistical packages for social sciences (SPSS 15) for Windows.Results: A total of 39 cases of colorectal carcinoma were included in this study. Majority of the patients (55.5%) was in 6th decade in MSI and 29.1% were MSI absent group. The mean age was found 47.67±10.97 years in present group and 47.84±14.26 years in absent group. The difference was not statistically significant (p>0.05). TNM stage with MSI was observed. The mean CEA level was 100.74±103.66 and 60.43±91.72. The mean Hb was 9.72±1.99 % and 9.92±2.17, the range was 7.2-12.2 and 4.6-13.4 among the groups. The mean difference was not statistically significant (p>0.05). Ulcerated was 3 (33.3%) and 19 (64.5%). Stage 3 tumor was 4 (44.4%) and 16 (51.6%). Grade 2 tumor was 5 (55.6%) and 17 (58.0%).Conclusions: For the first time in Bangladesh, this study was undertaken to evaluate the microsatellite instability (MSI) status in colorectal cancer tissue and their association with different histomorphological patterns of colorectal carcinoma.   


Author(s):  
Yostila Derosa ◽  
Nasrul Zubir ◽  
Raveinal Arnelis

Background: Hepatitis B is acute or chronic liver inflammation caused by hepatitis B viral and can progress to hepatic chirrosis or liver cancer. Chronic hepatitis B has a high risk for liver fibrosis. Chronic inflammation and liver fibrosis are interrelated processes. This study aimed to determine the differences in T-regulator cells, Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) between chronic hepatitis B patients with and without liver fibrosis.Method: This study used a cross-sectional method for patients diagnosed with chronic hepatitis B in the Inpatient and Outpatient Department of the Internal Medicine Department  DR. M. Djamil Padang and other hospitals in Padang city for 6 months. Samples were selected by consecutive sampling according to inclusion and exclusion criteria. Liver fibrosis is identified by fibroscan. Data were analyzed by SPSS 21.0.Results: thirty-two patients were diagnosed with chronic hepatitis B and 50% had liver fibrosis. The levels of T-regulator cells in chronic hepatitis B patients without liver fibrosis were 2.08% and liver fibrosis 2.25%, but this difference was not statistically significant (p 0.05). Mean ALT levels in the group without fibrosis were 19 IU/L (7IU/L-71IU/L) and liver fibrosis 61 IU / L (13IU/L-625IU/L). The mean AST level in the group without fibrosis were 15.5 IU/L (10IU/L-32IU/L) and liver fibrosis 35.5 IU/L (10IU/L-476IU/L). The difference between ALT and AST in the two groups was significant (p 0.05). Hepatitis B patients with liver fibrosis had higher ALT and AST levels than without fibrosis.Conclusion: There were differences levels of T-regulator cells in the two groups, but it was not statistically significant. ALT and AST levels were higher in the liver fibrosis group and statistically significant.


2021 ◽  
Author(s):  
Megan Fuerst ◽  
Kaitlin Schrote ◽  
Bharti Garg ◽  
Maria Rodriguez

Abstract Objective This study sought to determine if there was a difference in the months of oral contraception prescribed by physicians living in U.S. states with a 12-month supply policy compared to physicians in states without a policy. Methods We conducted an exploratory descriptive study using a convenience sample of Obstetrics & Gynecology resident physicians (n=275) in the United States. Standard bivariate analyses were used to compare the difference between groups. Results Few physicians in both groups (3.8% with a policy and 1.4% without a policy) routinely prescribed a 12-month supply of contraception. The mean coverage prescribed by providers in states with and without a policy was 2.81 and 2.07 months (p<0.05). Conclusions The majority of physicians were unaware of 12-month contraceptive supply policies and unable to correctly write a prescription for 12-months of contraception, regardless of whether they lived in a state with a 12-month contraceptive supply policy. Physician education may be needed to effectively implement 12-month contraceptive supply policies.


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