scholarly journals TO COMPARE THE EFFICACY OF PGE2 GEL AND 25ΜG OF INTRAVAGINAL MISOPROSTOL FOR INDUCTION OF LABOR IN TERM PROM

Author(s):  
Sunita Maheshwari ◽  
Shweta Jinger

Background: Induction of labour is one of the most common obstetric interventions worldwide. The study was conducted to compare the efficacy and safety of 25µg (low dose) vaginal Misoprostol with intracervical Dinoprostone for cervical ripening and induction of labour in term pregnancy. Methods: For the purpose of this study, 100 term pregnancy patients (only primigravidae and second gravidae) were included who had spontaneous rupture of membrane before onset of labor. Data was collected from cases admitted in labor room at Pannadhay Mahila Chikitsalaya associated with RNT Medical College,Udaipur between July 2014 to July 2015. Results: Requirement of Oxytocin for augmentation of labor between group A and group B. It is evident from the table that oxytocin was required in only 16% of patients in group A, while 46% in group B. This indicates that requirement of oxytocin was significantly less in misoprostol group (P<0.001). Conclusion: This study was designed to assess efficacy of a 25 μg misoprostol vaginal tablet, Finding confirms that vaginal misoprostol tablet is as effective as dinoprostone in cervical ripening and labour induction with dinoprostone. Keywords: Cervical ripening, Dinoprostone, Labour induction, Low- dose misoprostol.

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):  
Raj M. Mehta ◽  
Babulal S. Patel ◽  
Akshay C. Shah ◽  
Shashwat K. Jani ◽  
Vismay B. Patel ◽  
...  

Background: Induction of labour defined as artificial initiation of uterine contractions before the onset of spontaneous labour, after the period of viability, by any methods. The successful outcome depends on the Bishop Score, maternal age and parity. Authors compared the most preferred two routes; vaginal and oral for induction and outcome, adverse events and side effects were noted.Methods: This was a prospective comparative study carried out at SVPIMSR, Ahmedabad, from January 2019 to June 2019, Gujarat, 100 patients who required induction were randomly divided in two groups- Group A received 25µg oral misoprostol, Group B - received 25µg vaginal misoprostol repeated 4 hourly up to maximum five doses in both groups. The induction to delivery interval, mode of delivery, maternal and neonatal outcome and complications were observed.Results: The mean induction to delivery interval was less in vaginal group than oral (18.7 hours in vaginal versus 22.4 hours in oral). Vaginal delivery and caesarean section rates were comparable in both groups. 60% patients in Group A required more than two doses as compared to 36% in Group B. No major complications or adverse events were observed.Conclusions: Both oral misoprostol in a dose of 25μg and vaginal misoprostol 25μg every four hours, to a maximum of five doses, have safety and efficacy for induction. With The vaginal route, delivery occurs in less time and few doses required as compared to oral.


Author(s):  
Neelam Bhardwaj ◽  
Parveen . ◽  
Prerna . ◽  
Neeta Meena ◽  
Prem .

Background: Induction of labour is a common intervention, required in situations where continuation of pregnancy may be lifethreatening for the mother and/or fetus. In industrialized countries, the induction rate ranges from 10-25%. Methods: Randomized controlled trial was conducted at Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. Results: APGAR score at 1 min and 5 minutes was 6.64 and 6.84 in oral misoprostol and vaginal misoprostol group respectively, while at 5 minutes it is 6.7 oral group and 7 of vaginal misoprostol group. 34% of cases need NICU admission in Group-A (Oral misoprostol) and 14% in Group-B (Vaginal misoprostol) group. Meconium aspiration syndrome which is present 10% of patients in Group-A (Oral Misoprostol) while it is present in 6% of patients in Group-B (Vaginal misoprostol). Conclusion: The lesser incidence of meconium-stained liquor and NICU admissions and fewer caesareans with better neonatal outcome in women induced with oral misoprostol outweigh its advantages over the vaginal misoprostol Keywords: Misoprostol, Labor, Induction, Fetomaternal outcome.


Author(s):  
Renu K. Sinha ◽  
Santoshi Gupta

Background: At term, infection remains the most serious complication associated with PROM for the mother and the neonate Induction of labour significantly reduces the risk of maternal and foetal infection. This randomized comparative study has been done to compare the effectiveness and safety of low and high dosage (25 mcg and 50mcg) regimen of vaginal misoprostol for induction in term PROM patients.Methods: At term, infection remains the most serious complication associated with PROM for the mother and the neonate Induction of labour significantly reduces the risk of maternal and foetal infection. This randomized comparative study has been done to compare the effectiveness and safety of low and high dosage (25 mcg and 50mcg) regimen of vaginal misoprostol for induction in term PROM patients.Results: PROM to delivery interval was significantly shorter with 50mcg vaginal misoprostol as compared to 25 mcg vaginal misoprostol (15.71±3.29 hours vs. 18.23±3.23 hours, (p value = 0.0023) Number of doses required was less with 50mcg vaginal misoprostol group as compared to 25mcg vaginal misoprostol (1.22±0.42 vs. 1.91±0.80, p value <0.05). 83.6% women in group A and 69.09% women in group B underwent spontaneous vaginal delivery within 24 hours. 3.64% women in group A and 7.27% in group B had instrumental delivery. Caesarean section was performed in 12.27% cases in group A and 23.64% cases in group B. The complication rate was comparable.Conclusions: 50mcg vaginal misoprostol is more effective and safe for induction of labour at term PROM as compared to 25 mcg vaginal misoprostol 


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Hassan Swidan ◽  
Ahmed Abdel Shafy El-Shahawy ◽  
; Ahmed Mohamed Abbass ◽  
Huda Mohamed Elsayed Mohamed

Abstract Background Induction of labor should be used in the most efficient way possible that will result in a favorable obstetric outcome with minimum fetal morbidity. Objectives The aim of this study is to compare the efficacy and safety of intravaginal misoprostol alone versus intra cervical Foley catheter combined with vaginal misoprostol in induction of labor at term pregnancy. Methods This study was conducted at Obstetrics & Gynecology Department; Ain Shams University, Maternity Hospital in the period between May 2017 to October 2017. The total number of patients studied was 120 patients, divided into two groups; the first group (A) included 60 patients who received vaginal misoprostol, the second group (B) included 60 patients who received vaginal misoprostol combined with trans cervical Foley catheter. Results The current study found that the combined group has a better chance for NVD 88.3% versus 78.3% in misoprostol alone group, a lesser probability to CS 11.7% in combined group versus 21.7% in misoprostol alone group and a shorter induction delivery interval within 12 hours after induction (81.6% in combined group versus 59.5% in misoprostol group). Regarding the effect of both methods on fetal safety, we found that non reassuring FHR was more common in combined group 8.3% than misoprostol alone group 1.7% but it’s statistically non-significant. There was statistically significant increase in tachysystole in combined group 28.3% versus 13.3% in misoprostol alone group. However, dystocia was more common in misoprostol group 15% than combined group 3.3% that is also statistically significant. Conclusion Both methods can be used in induction of labor at term pregnancy without forgetting the precautions and close observation to the mother and the fetus. Combined method results in a shorter induction-to delivery time, but misoprostol alone was safer for the mother and the fetus.


2021 ◽  
pp. 50-52
Author(s):  
P. Shabana ◽  
R. Asha Latha ◽  
N. M. Riyaz Riyaz

Background:Induction of labour is the process of initiating the labour by articial means post 24 weeks of gestation. This study was undertaken to compare the efcacy and safety of vaginal Misoprostol [25-50ug] with intracervical Dinoprostone gel (0.5mg) for induction of labour at term in terms of efcacy of drug, feto-maternal outcome, side effects and complications of drugs. Methods: 400 nulliparas at term admitted in the OBG ward were included in this study. They were randomly allocated to two groups A& B. Group A (200 women) received tablet Misoprostol 25 micrograms vaginally 4 hrly to a maximum of 3 doses and Group B (200 women) received Dinoprostone gel 0.5mg intracervically 6 hrly to a maximum of 3 doses. Comparison was done in terms of induction to delivery interval, rates of instrumental and LSCS delivery, need for NICU care and cost-effectiveness. ADRs, if any were documented and proper care taken. Results: The mean induction to delivery interval was less in the Misoprostol group than Dinoprostone group (12 hrs vs. 22 hrs). 82% patients delivered in the rst 24 hrs in Misoprostol group compared to 54 % patients in Dinoprostone group. Group A had a higher success rate (80% vs.75%) and also required less augmentation of labor ( 35% vs. 65%) compared to group B. Need for LSCS was also lower in Misoprostol group (13% vs. 18%). Need for instrumentation and incidence of NICU admission was similar in both groups. Misoprostol was more cost effective compared to Dinoprostone. Conclusions: The Misoprostol group had a shorter induction to delivery interval, more number of deliveries in the rst 24 hrs of induction and a reduced need of augmentation of labor with oxytocin. There was no signicant difference in the rate of caesarean section, hyper-stimulation syndrome, neonatal and maternal morbidity between the two groups. Thus, Misoprostol appears to be safer, cheaper and more efcacious alternative for induction of labor especially for non-fetal indications as compared to Dinoprostone gel.


Author(s):  
Sumitra Gajraj ◽  
Anupam Kapur

Background: Aim of this study was to assess the maternal and fetal/neonatal outcome after the use of low dose (25 µg) misoprostol for labour induction in women with term pregnancy (gestational age >37 weeks POG) with a live foetus.Methods: The prospective interventional study was designed at the department of obstetrics and gynaecology of a tertiary health care hospital, with a sample size of 150 pregnant ladies who had to undergo induction of labour, were selected depending on the defined inclusion and exclusion criteria. Data was analysed using SPSS 18. Descriptive statistics were used to describe the data. Qualitative variables were presented as frequencies and percentage.Results: About 41% (61 patients) of the total study population was in the age group of 26 to 30 years with only two patients aged >35 years of age. The study group comprised of 88 primigravida (59%) and 62 multigravida (41%). The most common indication for induction of labour in my study was post-dated pregnancy (47%) followed by PROM (22%).Conclusions: The use of low dose (25 µg) misoprostol sublingually is definitely very effective in cervical ripening and induction of labour in term pregnancies particularly in those with poor Bishops score. There was no significant neonatal or maternal morbidity associated with induction of labour with low dose sublingual misoprotol. 


Author(s):  
Khushpreet Kaur ◽  
Balwinder Kaur ◽  
Navneet Kaur ◽  
Gagandeep Kaur

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.


2017 ◽  
Vol 8 (1) ◽  
pp. 50-54
Author(s):  
Sharmin Abbasi ◽  
Sehereen Farhad Siddiqua ◽  
Mohammad Noor A Alam ◽  
Suha Jesmin ◽  
Md Mahmudur Rahman Siddiqui ◽  
...  

Background: Intrauterine fetal death is means- intrapartum death after the fetus has reached the age of viability8. As in IUFD journey, labor pain will be fruitless. So, it is of utmost importance to search for the method which can reduce hours of pain in labor of IUFD cases.Metarials Methods: In this research work patients divided in two groups. Induction of labour in one group was given by combination of mifepristone and misoprostol other group by misoprostol only and we try to find out the best method. To compare the effectiveness, induction to delivery interval, safety and side effects of combination of mifepristone and misoprostol versus conventional use of misoprostol alone in induction of labour in patients with intrauterine fetal death. It is a Prospective randomized comparative study in Anwer Khan Modern Medical College Hospital and Dhaka Medical College Hospital among 70 patients with IUFD after 28 weeks of gestation during January 2014- January 2016.Result: We allowed the patients up to third gravid and after 28 weeks of gestation. Patients were grouped as Group A(35) & Group B (35). In Group A Induction was given by single oral dose of 200 mg mifepristone, and after 48 hours, tab. Misoprostol in post. fornix started if <34 weeks-100 ?gm dose and >34 weeks-50 ?gm dose. Doses were repeated every 6 hourly intervals if required. In Group B Induction was given by 100 ?gm misoprostol at 6 hourly interval in post. Fornix. In both groups we allowed misoprostol maximum 600 ?gm. Oxytocin was given for augmentation if needed. The two study groups did not differ demographically. Induction to delivery time was shorter with combined regimen group (P<0.001). Induction to delivery interval ranges from 10-12 hours in mifepristone plus misoprostole group.In only misoprostol group it was about 24-26 hours. Doses of misoprostol was lower in combined group (P<0.001). 4 patients need Oxytocin for augmentation in only misoprostol group. In combined group oxytocin was not needed. The two groups did not differ as regards complications experienced during labour and delivery significantly. In overall out come 2 failed induction in misoprostol only group but not in combinedgroup.Conclusion: In Induction of IUFD mifepriston plus misoprostol is an effective combined group. It is safe, non invasive, easily tolerable, highly cost effective, had less induction to delivery interval, required less dose of misoprostol and no need of augmentation with oxytocin. So,the combined group is more effective than conventional regimen of misoprostol alone.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 50-54


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