scholarly journals Safety and efficacy of vaginal misoprostol versus transcervical foley catheter and intravenous oxytocin for induction of labour

2014 ◽  
Vol 3 (2) ◽  
pp. 12-15
Author(s):  
Ernest O Orji

Introduction: A variety of drugs were used for induction of labour, but only oxytocin and prostaglandins have survived critical test of effectivity with a minimum of side effects for mother and child. The objective of this study is to compare efficacy and safety of vaginal misoprostol with transcervical Foley’s catheter and intravenous oxytocin for induction of labour. Methods: Eighty women at term gestation with the Bishops score < 4 with various indications for labour induction were randomly allocated to receive 25 microgram misoprostol vaginally 4 hourly (maximum 6 doses) or transcervical Foley’s catheter with intravenous oxytocin (2mU/minute to a maximum of 32mU/ minute). There were 40 women in each group. Result: In the misoprotol group induction delivery interval was significantly less (5.50 versus 15.0 hours) and successful induction significantly higher (95% versus 75%) as compared to catheter/oxytocin group. There were more cases of hyperstimulation with misoprostol; however neonatal outcome was similar in both groups. There were more vaginal delivery and less caesarean section in misoprostol compared to Foley’s catheter/oxytocin group. Conclusion: Vaginal misoprostol is highly effective, safe to administer as an agent for induction of labour DOI: http://dx.doi.org/10.3126/njog.v3i2.10825   Nepal Journal of Obstetrics and Gynaecology Vol.3(2) 2008; 12-15

Author(s):  
Priyanka . ◽  
Shashi Bala Arya ◽  
Mirdu Sinha ◽  
J. K. Goel

Background: Induction of labour implies stimulation of uterine contraction before spontaneous onset of labour with or without ruptured membranes. Aim of this study was to compare the efficacy and safety of intracervical Foley’s catheter with oxytocin and vaginal misoprostol for labour induction at term.Methods: A total 100 term pregnant women were chosen with bishop score <6 and divided into two groups: Foley’s catheter with oxytocin (Group A) and vaginal misoprostol (Group B). In Group A, a 16 F Foley’s catheter introduced beyond internal os and traction applied every 4 hourly to check for expulsion with simultaneous oxytocin infusion (2 mU/min up to 32 mU/min). In Group B, 25 mcg misoprostol administered every 4 hourly (maximum 6 doses or 150 mcg). Data analysed using SPSS software 20.0. A p value <0.05 was considered statistically significant.Results: No statistical difference found between demographic variables between two groups. Both primigravida and multigravida had poor pre-induction bishop score in both groups. Foley’s catheter (80%) and misoprostol group (96%) had successful induction and was statistically significant (p<0.05). Foley’s catheter took more time from induction-delivery both in primigravida and post-dated pregnant women. The rate of cesarean in Foley’s catheter group was high (62.5%) including 33% cases with failed induction. Foley’s catheter had less maternal and neonatal complications, less NICU admission as compared to misoprostol (p>0.05).Conclusions: Misoprostol was found better for successful induction, decreases induction-to-delivery interval and increases vaginal delivery as compared to Foley’s catheter but it needs constant supervision in view of hyperstimulation and tachysystole.


Author(s):  
Anjali R. Kanada ◽  
Mahima Jain

Background: In cervical ripening, before induction of labour, is needed to increase the success of labour induction, to reduce complications and to diminish the rate of caesarean section and duration of labour. Pharmacological preparations are in widespread use for cervical ripening but are not free from side-effects and complications. Mechanical methods, i.e. the use of Foley’s catheter balloon, though effective have not gained much popularity because of the fear of infection. Therefore, the study has been conducted to prove the efficacy and safety of extra amniotic Foley catheter balloon and to compare it with intra-cervical prostaglandin E2 (PGE2) gel. The objective of the study was to the success of induction of labor depends on the cervical status at the time of induction. For effective cervical ripening both Foley's catheter and PGE2 gel are used. The aim of this study was to compare the efficacy of intra cervical Foley's catheter and intra cervical PGE2 gel in cervical ripening for the successful induction of labor.Methods: A randomized, comparative study was conducted in the department of obstetrics and gynaecology, Civil hospital, B.J. Medical College Ahmedabad, during a period of 8 month from September 2018 to April 2019. 100 patients at term with a Bishop's score ≤5 with various indications for induction were randomly allocated to group F (intra-cervical Foley’s catheter) and group P (PGE2 gel) with 50 women included in each group.Results: The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed significant change in the Bishop's score, 5.10±1.55 and 5.14±1.60 for Foley's catheter and PGE2 gel, respectively, p <0.001. However there was no significant difference between the two groups. There was no significant difference in the side effects and caesarean section rate in both groups. The induction to delivery interval was 16.01±5.50 hours in group F and 16.85 ± 3.81 hours in group P (p=0.073). Apgar scores, birth weights and NICU admissions showed no significant difference between the two groups.Conclusions: The study shows that both Foley's catheter and PGE2 gel are equally effective in pre induction cervical ripening.


2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Nasreen Noor ◽  
Mehkat Ansari ◽  
S. Manazir Ali ◽  
Shazia Parveen

Objectives. To compare the efficacy and safety of intravaginal misoprostol with transcervical Foley catheter for labour induction.Material and Methods. One hundred and four women with term gestation, with Bishop score < 4, and with various indications for labour induction were randomly divided into two groups. In Group I, 25 μg of misoprostol tablet was placed intravaginally, 4 hourly up to maximum 6 doses. In Group II, Foley catheter 16F was placed through the internal os of the cervix under aseptic condition and then inflated with 50 cc of sterile saline. Statistical analysis was done using SPSS software.Results. The induction to delivery interval was 14.03 ± 7.61 hours versus 18.40 ± 8.02 hours (p<0.01). The rate of vaginal delivery was 76.7% versus 56.8% in misoprostol and transcervical Foley catheter group, respectively. Uterine hyperstimulation was more common with misoprostol. Neonatal outcome was similar in both the groups.Conclusion. Intravaginal misoprostol is associated with a shorter induction to delivery interval as compared to Foley’s catheter and it increases the rate of vaginal delivery in cases of unripe cervix at term. Transcervical Foley catheter is associated with a lower incidence of uterine hyperstimulation during labour.


Author(s):  
Shobha Bembalgi ◽  
Lavanya . ◽  
Vinutha M. B.

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.


Author(s):  
Jaydeep J. Bhatu ◽  
Disha Patel

Background: Cervical Foley’s catheter used now a days for induction of labour alone as well as a combined with cerviprim gel. The objective of the study was to assess the effectiveness of 750 cc traction on Foley catheter with no traction for labour induction in >37 weeks pregnancy.Methods: A randomized controlled trial performed on pregnant women at >37 weeks who were admitted for induction of labour with unfavourable cervix. They were randomly assigned into two groups, Foley’s with 750 cc traction and without traction. The primary outcomes were improvement in Bishop Score, number of favourable cervix following induction and the mode of delivery. The secondary outcomes were neonatal outcome, and maternal infection.Results: A total of 80 pregnant women were randomized into traction group (n=46) and non-traction group (n=34). Traction group had significantly (p=0.0462) higher number of vaginal delivery compared to non-traction group. Participants were comfortable using both methods. There was no difference in neonatal outcomes and risk of maternal infections in both groups.Conclusions: Application of traction did result in more vaginal delivery.


Author(s):  
Ambika H. E. ◽  
Swathi Bhat ◽  
Lepakshi B. G. ◽  
Savitha C. S.

Background: It was a randomized controlled prospective study. A large number of women in their advanced pregnancies often need labour induction for various reasons. This study aims to evaluate a safe, effective and inexpensive mode of medical induction. The purpose of the study is to evaluate the safety and efficacy of vaginal misoprostol versus oral misoprostol in induction of labour when used in equal doses.Methods: Two hundred patients were included in the study. They were divided into two groups of 100 patients each. One group i.e. Group A received vaginal misoprostol while the other group i.e. Group B received oral misoprostol. The dosage was 50μg every 6th hourly maximum of four doses. The progress of labour in both groups was charted on a partogram. The outcome of pregnancy, maternal and foetal outcomes were statistically analysed.Results: When compared with respect to age, height, gestational age, indication for induction, there was no difference in either of the groups. The numbers of doses of misoprostol for successful outcome of labour in the vaginal group i.e. 2.25±0.53 was lesser than the dosage needed in the oral group i.e. 2.71±0.60 (P value M 0.0001). which is highly significant. The induction-delivery interval was also less in the vaginal group compared to the oral group. (12.90±2.40 hours versus 15±75 hours). Only 13 women in the vaginal group needed acceleration with oxytocin in contrast to 17 women in the oral group. The need for caesarean section in women induced with vaginal misoprostol was 12 women in comparison to oral group which was 32 women. No statistically significant difference was seen in neonatal outcome in either of the groups.Conclusions: When given in equal doses the vaginal administration of misoprostol is more effective in successful induction of labour when compared to oral misoprostol.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Chidebe C. Anikwe ◽  
Bartholomew C. Okorochukwu ◽  
Emmanuel Uchendu ◽  
Cyril C. Ikeoha

Background. Induction of labour is not without risk, and it calls for a method that will be sensitive enough to predict successful labour induction. Aim. This study aims to evaluate the role of transvaginal ultrasonographic cervical length measurement at term in the prediction of successful induction of labour (IOL). Materials and Methods. This prospective study was carried out in the Department of Obstetrics and Gynaecology of Federal Teaching Hospital Abakaliki between 1st of July and 30th of November 2015. Preinduction Bishop score and cervical length were assessed before induction of labour. Intracervical, cervical, extraamniotic Foley catheter was used to improve the Bishop score. The data were analyzed using the IBM SPSS Statistics 20. Results. The mean maternal age of the study group was 30.68 ± 6.38 years with a range of 19–43 years. The mean gestational age and parity were 39.57 ± 1.49 and 1.85 ± 0.63, respectively. All the women studied had successful induction of labour with mean induction delivery time of 8.1 ± 3.0 hours and mean duration of labour of 7.4 ± 2.9 hours. Preinduction cervical length is a good predictor of a short duration of labour (P=0.001). Parturient with a preinduction cervical length of less than 3 cm was likely to have labour lasting less than 6 hours (RR = 4.20 (95% CI 1.85–9.529). Conclusion. Transvaginal sonographic measurement of cervical length provides a useful prediction of the likelihood of duration of labour following the induction of labour. It is recommended that IOL should be considered and success anticipated in a parturient with a cervical length less than 3 cm.


Author(s):  
Kala K. ◽  
Anupama V. Rani ◽  
Dharmavijaya M. N. ◽  
Umashankar K. M.

Background: Misoprostol is a prostaglandin E1 analogue, a methyl-ester of prostaglandin E1 additionally methylated at C-16. Misoprostol is an effective myometrial stimulant of pregnant uterus, selectively binding to prostanoid receptors. The objective of the study was to compare the efficacy of vaginal and oral misoprostol for the induction of labour in women with intra-uterine foetal death (IUFD).Methods: A prospective randomised clinical trial, comparing 50µg oral and 50µg vaginal misoprostol, six hourlies for a maximum of four doses for the induction of labour in women with IUFD. All patients with IUFD after 28 weeks without previous uterine surgeries, without contraindications for prostaglandins are included in the study. The study was conducted in the Department of Obstetrics and Gynecology MVJ Medical College and Research Hospital, Hoskote. Bangalore from June 2012 to June 2015. It is a tertiary institution serving predominantly rural population. The primary outcome measure was the induction to delivery time, secondary all complications were noted.Results: Twenty-five women were randomised to the vaginal route and twenty-five to the oral route. The induction to delivery time was longer with vaginal misoprostol 10.5±4.03 compared to oral misoprostol (9.58±4.9). There was no significant difference in the amount of misoprostol needed to achieve successful induction in the two groups. 3 patients needed oxytocin augmentation to complete the induction of labour. There were no cases of failed induction. The systemic side effects (shivering, diarrhoea, vomiting and pyrexia) were more common with oral misoprostol (44.5%) compared to vaginal misoprostol (20%).Conclusions: Oral misoprostol achieved successful induction of labour in women with IUFD in a shorter time than vaginal misoprostol. Both routes are equally effective in termination of pregnancy. Sublingual route is easy to administer, patient compliant, no need for internal examination, less chance of labour dysfunction, less chance of post-partum sepsis.


2021 ◽  
Vol 10 (4) ◽  
pp. 3241-3243
Author(s):  
Megha bandil

Pregnancy termination in the second trimester is riskier than in the first. The primary objective is to create a more effective means of termination while also reducing induction time. To compare the efficacy, safety, and acceptability of intra-cervical foley's catheter with vaginal misoprostol versus vaginal misoprostol for second-trimester pregnancy termination. This clinical study involved 400 pregnant women who were scheduled to have their pregnancy terminated between 13 and 22 weeks of pregnancy for any reason. The enrolled women were divided into two categories: Category I (Misoprostol category): intra-cervical Foley’s catheter inserted with a standard regimen of moistened misoprostol tablets (400 g) 4 hourly inserted vaginally to a maximum of 5 doses; Category II (Combined category): intra-cervical Foley catheter inserted with a standard regimen of moistened misoprostol tablets (400 g) 4 hourly inserted vaginally to a maximum of 5 doses 4 hourly intra-vaginal injections were employed. Misoprostol was retained in the posterior fornix, and the dose was repeated every 4 hours until the catheter was removed, or until a maximum of five doses had been administered. The mean induction to abortion interval in the misoprostol category was 15.38 + 1.25 hours and 8.25 + 2.25 hours in the combination category, which was statistically significant (p= 0.001). The misoprostol category had a 94 percent success rate, while the combined category had a 97 percent success rate. The use of a combined intra-cervical foley's catheter and vaginal misoprostol to end a pregnancy in the second trimester is a novel, safe, effective, and acceptable procedure.


2020 ◽  
Vol 3 (1) ◽  
pp. 105-112
Author(s):  
Baburam Dixit Thapa ◽  
Tara Manandhar ◽  
Sarita Sitaula ◽  
Tulasa Basnet

Introduction: Induction of labor is done with the aim of normal vaginal delivery. There are different methods; mechanical like intra-cervical Foley’s or pharmacological agents like misoprostol ordinoprostone. Objectives: To compare sequential use of Foley’s catheter and vaginal misoprostol in comparison with vaginal misoprostol only. Methods: Patients with period of gestation more than or equal to 41 weeks without any complications were assigned randomly according to computer generated randomization into sequential use ofintracervical Foley followed by vaginal misoprostol after 24 hours (sequential group) or vaginalmisoprostol only. Primary outcome was rate of normal vaginal delivery. Secondary outcomes were induction to delivery interval, maternal and fetal morbidity. Results: Rate of normal vaginal delivery in sequential group (n= 353) and misoprostol alone group(n= 356) was 71.6% and 53.3% (p < 0.001) but the time to delivery from induction is statistically more in sequential group (30.3 vs. 11.2 hours, p< 0.001). Maternal outcomes like postpartum hemorrhage, hyper-stimulation syndrome, chorioamnitis and neonatal outcomes like low Apgar score, meconium stained baby and stillbirth are similar in both the groups. Conclusions: The priming of cervix using intracervical Foley catheter before giving vaginalmisoprostol was beneficial in increasing the rate of normal vaginal delivery but it increased the induction to delivery interval.


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