Effect of Tafoxiparin on Cervical Ripening and Induction of Labor in Term Pregnant Women With an Unripe Cervix

Abstract Background The use of COOK balloon in the process of induction of labor is gradually promoted. This study was conducted to investigate the safety and efficacy of COOK double balloon dilation for pre-induction cervical maturation and induction of labor. Methods A total of 343 pregnant women with full-term pregnancy in Shanghai Putuo Maternity & Infant Health Hospital from January 1st to September 30th of 2016 were enrolled. Of all the pregnant women, 166 had labor induction, which included the use of a COOK balloon, the implementation of artificial rupture of membranes (AROM) and oxytocin intravenous (IV) drip (COOK group). The other 177 pregnant women with spontaneous rupture of membranes (SROM) and mature cervix only administrated with oxytocin IV drip to promote regular uterus contraction (oxytocin group). Maternal adverse reactions, mode of delivery and delivery outcomes of two groups were subsequently compared between the two groups. Results There were significant differences of maternal age (28.29 ± 3.34 vs. 29.25 ± 3.62 years, P = 0.02), gestational age (283.49 ± 4.53 vs. 274.71 ± 7.04 years, P < 0.001) and birth weight (3435.27 ± 340.29 vs. 3354.63 ± 387.96 g, P = 0.02) between the COOK group and the oxytocin group. There were no significant differences in terms of gravidity, parity, mode of delivery, analgesia, 1 min and 5 min Apgar score, labor time, postpartum hemorrhage, and adverse events. Conclusion Use of a COOK balloon may help full-term pregnancy women with immature cervix obtain the same pregnancy results as those with mature cervix, without extra occurrence of adverse events.Trial registration This is an observational study and no registration is required.

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A randomized prospective comparative study to evaluate the efficacy of prostaglandin E2 (Dinoprostone) controlled release vaginal insert versus sublingual prostaglandin E1(Misoprostol) in induction of labor in term gestation

Indian Journal of Obstetrics and Gynecology Research ◽

10.18231/j.ijogr.2021.096 ◽

2021 ◽

Vol 8 (4) ◽

pp. 457-462

Author(s):

Rakhee Sahu ◽

Kirti Janjewal

Keyword(s):

Comparative Study ◽

Pregnant Women ◽

Fetal Outcome ◽

Induction Of Labor ◽

Induction Of Labour ◽

Cervical Ripening ◽

Significant Difference ◽

Misoprostol Group ◽

Prospective Comparative Study ◽

The Mean

In modern obstetrics, one of the common challenges is induction of labour (IOL). WHO Global Survey reported that IOL accounted for 9.6% of all deliveries. Prostaglandins have evolved and frequently used pharmacologic agents for IOL, owing to their dual action of cervical ripening and uterine contraction inducing effect. : 1. To compare the efficacy and induction to delivery interval (IDI) of PGE2 vaginal insert and Sublingual PGE1 in induction of labor in term pregnant women; 2. To study the maternal and fetal outcome in both groups.: This a randomized, prospective, comparative study of 100 term pregnant women for induction of labour. Group 1-(50 women) PGE2-10mg vaginal insert and group 2-(50 women) PE1 Sublingual tablets – maximum 200 mcg in 24 hrs, at Dr LH Hiranandani Hospital, Mumbai, India.: In my study the mean induction to delivery interval in Dinoprostone group was 17.47 hours and 23.44 hours in Misoprostol group. So the mean IDI was shorter in Dinoprostone insert group than Misoprostol group by about 6 hours. There was no significant difference noted in terms of overall incidence of caesarean deliveries among the groups. Our study concluded that Dinoprostone 10mg vaginal insert was more efficacious than sublingual Misoprostol in reducing induction to delivery interval without maternal and fetal complications.Our study suggests that the Dinoprostone vaginal insert can be used as both inducing as well as augmentating agent in labour. Dinoprostone vaginal insert maybe more effective in reducing the incidence of caesarean sections.

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Role of Dexamethasone in Induction of Labor: (A Randomized Clinical Trial)

QJM ◽

10.1093/qjmed/hcaa056.011 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

H M Elsayed ◽

A M Bahaa ◽

A A Alanwar ◽

K M Mohamed

Keyword(s):

Pregnant Women ◽

Statistical Difference ◽

Active Phase ◽

Maternity Hospital ◽

Induction Of Labor ◽

Cervical Ripening ◽

Control Group ◽

Significant Statistical Difference ◽

Phase Interval ◽

Group D

Abstract Background Labor induction is a common obstetric procedure which is done for many indications. Ripening of the cervix is a complex process involving hormonal, vasodilatory and inflammatory changes. There are broad range of methods for cervical ripening and induction of labor. Aim of the study: to assess the efficacy of intramuscular administration of dexamethasone on the induction delivery-interval in full term women undergoing induction of labor. Patients and Methods This study was carried out between July 2018 and January 2019, at the labor ward of Ain Shams university maternity hospital, a double bind randomized control trial of 80 pregnant women undergoing induction of labor after obtaining the approval of the local ethical committee and a fully-informed written consent. They were randomized into two groups: group D (Dexamethasone group n = 40) and group C (control group n = 40). Results Of 80 pregnant women undergoing induction of labor there were no statistically significant differences between the two groups as regard their age, body mass index, gestational age and bishop score at time of intervention. There was significant statistical difference between the two groups as regard induction-active phase interval (P < 0.05), mean induction-active phase interval in group D was (4.91±.85 hours) while in group C was (5.44±.83 hours). There was no significant statistical difference between the two groups as regard duration of active phase of labor, mean duration of active phase in group D was (4.10±.97 hours) and in group C (4.47±1.20 hours). There was significant statistical difference between the two groups as regard induction-delivery interval (P < 0.05), mean induction-delivery interval in group D was (9.73±.1.52hours) while in group C was (10.70±1.87 hours). There were no statistically significant differences between the two groups as regard duration of 2nd and 3rd stages of labor. Conclusion Single intramuscular injections of 2 ml. (8mg) of dexamethasone before induction of labor seems to shorten induction-delivery interval by shortening the induction-active phase interval.

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Role of dexamethazone on cervical ripening and induction of labor in term pregnancy

Zagazig University Medical Journal ◽

10.21608/zumj.2019.17069.1526 ◽

2019 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Tarek Saleh Zaher ◽

Mahmoud Gharib ◽

Amal El Saied ◽

Abdelaziz Amin

Keyword(s):

Induction Of Labor ◽

Cervical Ripening ◽

Term Pregnancy

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

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181995 ◽

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.

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

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20173497 ◽

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.

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