scholarly journals COMPARATIVE STUDY BETWEEN OXYTOCIN AND PROSTAGLANDIN IN INDUCTION OF DELIVERY IN POST TERM PREGNANCY

Author(s):  
Bushra Hashim Hameed ◽  
Walaa Abdulameer Mahdi ◽  
Suhad Abbas Jasim

Induction of delivery using medication can be performed by stimulating uterine contractility for establishing delivery prior to the start of spontaneous labor. Two most common ecbolic are Oxytocin and prostaglandins analogues (PGs) e.g. misoprostol. The study aims to compare between the effects of oxytocin & misoprostol in ripening of the cervix and induction of delivery in postdate pregnancy. Results show that the induction delivery period mean was significantly higher when using misoprostol than when using oxytocin. No significantly different results between the both groups regarding uterine hyperstimulation. No significantly different results between the both groups regarding postpartum hemorrhage. No significantly different results between the both groups regarding the mode of delivery. No significantly different results between the both groups regarding Cesarean section indication. No significantly different results between the both groups regarding the mean of Apgar score at 1 and 5 minutes. No significantly different results between the both groups regarding meconium aspiration. No significantly different results between the both groups regarding emergency Cesarean section rate due to fetal distress (pathological fetal heart rates) between the two groups. There was no significant difference between the two groups as regards the neonatal admission to the intensive care unit (N.I.C.U). It is concluded that Usage of both IV oxytocin 5 mIU/minute & vaginal misoprostol 25 µg is safe to induce delivery. It is preferable to use IV oxytocin 5 mIU/minute if the time factor is considered. Keywords: oxytocin, prostaglandin, induction of delivery, postdate pregnancy

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Asli Goker ◽  
Emre Yanikkerem ◽  
M. Murat Demet ◽  
Serife Dikayak ◽  
Yasemin Yildirim ◽  
...  

There are various factors related to postpartum depression. In this study we have aimed to determine the effect of mode of delivery on the risk of postpartum depression. A total of 318 women who applied for delivery were included in the study. Previously diagnosed fetal anomalies, preterm deliveries, stillbirths, and patients with need of intensive care unit were excluded from the study. Data about the patients were obtained during hospital stay. During the postpartum sixth week visit Edinburgh postnatal depression scale (EPDS) was applied. There was no significant difference between EPDS scores when compared according to age, education, gravidity, wanting the pregnancy, fear about birth, gender, family type, and income level (). Those who had experienced emesis during their pregnancy, had a history of depression, and were housewives had significantly higher EPDS scores (). Delivering by spontaneous vaginal birth, elective Cesarean section, or emergency Cesarean section had no effect on EPDS scores. In conclusion healthcare providers should be aware of postpartum depression risk in nonworking women with a history of emesis and depression and apply the EPDS to them for early detection of postpartum depression.


Author(s):  
Beenakumari R. ◽  
Radhamani Mavunkal Viswanathan ◽  
Nithya R.

Background: Misoprostol is the latest drug for induction of labour which is cheap and stable at room temperature. Our study was conducted to test the efficacy of misoprostol for labor induction through oral and vaginal route.Methods: 250 women who required induction of labor at Govt. Medical College, Kottayam was included in this study. Both oral misoprostol 50µg and vaginal misoprostol 25µg 4 hourly upto maximum of four doses were used for induction of labor as per consultant’s preference. Out of these 125 patients were selected for study in both groups. Singleton term pregnancies with cephalic presentation were selected. The mean induction pain interval, induction delivery interval, mode of delivery, maternal complications like uterine contraction abnormalities, neonatal complications were observed.Results: Induction to pain interval was shorter in oral misoprostol group compared to vaginal misoprostol group (2.48+1.3 hours vs. 3.91+2.17 hours P ≤0.001). But the mean induction to delivery interval was comparable in both groups (12.98±3.04hrs vs. 12.59±3.28 hrs.) Vaginal delivery and cesarean section rate in both groups were comparable. The oral group required more number of misoprostol (>2 misoprostol 38.4% in oral 25.6% in vaginal p=0.030). There was insignificant increased incidence of uterine hyperstimulation in vaginal group. The neonatal outcome was comparable.Conclusions: Misoprostol administered either by oral or vaginal route was equally effective in induction of labor and found to be safe.


2021 ◽  
Vol 23 (4) ◽  
pp. 329-333
Author(s):  
Hima Rijal ◽  
Suvana Maskey

Postnatal period is considered as an important part in reproductive life of women. Even though the antenatal phase and labour are utmost important, puerperal phase of pregnancy cannot be overlooked. Puerperal complication can sometime lead to diabilities for lifelong of women. For the prevention of postnatal complication, antenatal prepadareness is needed. The objective of this study was to find out the incidence of puerperal complications and associated risk factors. This is a retrospective, descriptive study conducted at Tribhuvan University Teaching Hospital, Department of Obstetrics and Gynaecology from April 2019 to March 2020. The cases of puerperal complications were noted from the record book from ward. The individual files were collected from record section. Data was collected from record files and analysed. Total number of deliveries were 4932 in one year. Out of which, 84 cases (1.7%) were admitted due to various puerperal complications. Majority of the women admitted with puerperal complications were between 21-29 years, 59.5%. Sixty-four percent (n=54) were primipara and 35.7%(n=30) were multipara. Seventy-six (90.5%) were term deliveries, 6(7%) were preterm and 2(2.4%) were post term deliveries. Sixty-two (74%) had emergency cesarean section as mode of delivery. Major indication of emergency cesarean section was fetal distress (29.8%, n=25). Surgical site infection (53/84,63%) was the commonest puerperal complication followed by puerperal sepsis (8/84,9.5%). Fifty- three cases of surgical site infection (SSI) were observed in patients who had undergone emergency cesarean section. Associated medical condition like hypertension, diabeties, anemia, obesity was seen in 33.5% (n=33) of the cases. Surgical Site Infection is the most common puerperal complication and commonly seen in women who had undergone emergency cesarean section.


Author(s):  
Jyoti Bindal ◽  
Geetanjali Munda

Background: Cesarean section is one of the commonest hospital based surgical procedure in obstetric mainly done to facilitate delivery in case where vaginal delivery is either not feasible or poses undue risk to mother, baby or both. The most common complications of CS are superficial surgical site complications including sepsis, seroma formation and breakdown.Methods: A prospective study done on 100 patients admitted in labour room of Department of Obstetrics and Gynaecology, Kamla Raja Hospital, G.R.M.C., Gwalior between November 2015 to March 2016. Study divided into two groups: group I, including women who had no subcutaneous drain left and group II, including women who had a subcutaneous drain left before closure of the skin; Each group has 50 patients. The study included term pregnant women with pre-operative Hb >9 gm%, BMI >30 kg/m2 and were taken for emergency cesarean sections (for cephaloppelvic disproportion, fetal distress, abnormal presentations) with no intraoperative complications (hemorrhage, blood transfusion).Results: VAS median grade in patients without drain was G3 (46%), followed by G2 (28%), G4 (14%). VAS median grade in with drain group was G2 (68%), followed by G1 (24%) and then G3 (08%). Wound infection was noted in 4 (08%) patients in both the groups. Both groups were administered same group of intravenous antibiotics for 5 days. The mean hospital stay in patients without drain were 9.4 days and patients with drain were 8.2 days. The mean haemoglobin in patient with drain was 8.6 gm% and patients without drain was 9.4 gm%. Wound seroma in 13 cases and superficial breakdown in 4 cases in non-drain group versus 5 cases and 2 cases in drain group respectively. There is significant difference in postoperative pain and non-significant difference in postoperative fever.Conclusions: Patients in with drain group have reduced rates of wound seroma, postoperative pain, shorter hospital stay, but there is insignificant benefit regarding post-operative fever, superficial SSI, wound breakdown and hemoglobin concentration.


Author(s):  
Madeeha Malik ◽  
Zirwa Asim ◽  
Azhar Hussain

Objective: The present study was designed to evaluate women postpartum quality of life after different modes of delivery in Pakistan.Methods: A descriptive cross-sectional study design was used. A pre-validated tool SF-36 was self-administered to a sample of 382 women in the postpartum period (6-8 w, 10-12 w, 14-16 w,>9 mo,>15 mo) undergone through elective/emergency cesarean sections or normal vaginal delivery and had delivered a single live child. After data collection, data was cleaned coded and entered in SPSS version 21.0. Descriptive statistics comprising of frequency and percentages was calculated. The non-parametric tests including Mann-Whitney and Kruskal-Walis (p ≥ 0.05) were performed to find out the difference among different variables.Results: Comparison of HRQOL domains by mode of delivery using Mann-Whitney test demonstrated a significant difference (p=0.01) between normal delivery and cesarean section. Women undergoing normal delivery had significantly higher scores as compared to women having cesarean section. Also, a significant difference (p=0.027) among HRQOL scores was observed between working women and house wives and as well who had better socioeconomic status (p=0.018).Conclusion: The results of the present study concluded that postpartum quality of life of most of the women undergoing normal vaginal delivery was better as compared to women undergoing cesarean sections in twin cities of Pakistan. Surgical intervention during cesarean section might lead to consistent postpartum pain, inability to cope with needs of newborn and family which in turn can reduce postpartum quality of life among women.


2010 ◽  
Vol 49 (177) ◽  
Author(s):  
R Shakya ◽  
J Shrestha ◽  
P Thapa

INTRODUCTION: The study compares safety and efficacy of misoprostol and dinoprostone as cervical ripening agents. METHODS: Patients with term, vertex, singleton pregnancy and Bishop score of 4 or less were randomly assigned to receive misoprostol pessary (n=35, 50 microg intravaginally) or dinoprostone gel (n=31, 0.5 mg intracervically) at 6 hourly intervals. If there were no progress in cervical dilatation or effective uterine contraction even after maximum dose, patients were taken for cesarean section. Patients who achieved Bishop's score more than 7 but the delivery was not progressing, were augmented with oxytocin drip. RESULTS: No uterine hyperstimulation was observed in both groups. However, abnormal fetal heart rate was observed in 3(8.6%) cases inmisoprostol group and 2 (6.5%) in dinoprostone group. There was no statistically significant difference in meconium passage in two groups. Apgar score less than 7 at 1 minute was seen in 6 (19.4%) and 11 (31.4%) neonates in dinoprostone and misoprostol group respectively. However Apgar score less than 7 at 5 minutes was found in only one neonate of dinoprostone treated patient. Both drugs were found to be equally effective in improving Bishops score with no significant difference in mean induction to delivery time. Cesarean section was done among 32.3% and 28.6% respectively in dinoprostone and misoprostol groups. There was significant reduction in the need for oxytocin augmentation in misoprostol (37.1%) group than in dinoprostone (67.7%) group. CONCLUSIONS: Vaginal misoprostol is an effective, safer and cheaper alternative to dinoprostone as a cervical ripening agent in underdeveloped countries. Keywords: Apgar score, Bishops score, cervical ripening, Dinoprostone, induction, Misoprostol


2013 ◽  
Vol 70 (3) ◽  
pp. 255-258 ◽  
Author(s):  
Sasa Ljustina ◽  
Ivana Berisavac ◽  
Milica Berisavac ◽  
Ljudmila Kovacevic-Vukolic ◽  
Vesna Velickovic-Aleksic ◽  
...  

Background/Aim. Preterm birth is the leading cause of neonatal mortality. Periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH) remains a significant cause of both morbidity and mortality in infants prematurely born. The aim of the study was to evaluate the perinatal outcome regarding IVH of premature babies according to the mode of delivery. Methods. A total of 126 women in preterm singleton pregnancies with vertex presentation and 126 neonates weighted from 750 g to 1,500 g at birth were enrolled. The outcomes of 64 neonates born vaginally were compared to 62 neonates born by cesarean section. Results. There was no significant difference in the incidence of IVH among both groups. Conclusion. Our data is consistent with the hypothesis that the mode of delivery does not influence IVH and consenquently perinatal outcome in preterm neonates.


2015 ◽  
Vol 3 (2) ◽  
pp. 237-240 ◽  
Author(s):  
Vlora Ademi Ibishi ◽  
Rozalinda Dusan Isjanovska

BACKGROUND: Pre-labour Rupture of Membranes (PROM) is an important cause of maternal and fetal morbidity and increased rate of cesarean section delivery. AIM: The aim of this study is to investigate the clinical characteristics, PROM-delivery interval, mode of delivery, and early maternal neonatal outcome among pregnant patients presenting with pre-labour rupture of membranes.MATERIAL AND METHODS: This prospective case control study is implemented at the Obstetric and Gynecology Clinic of the University Clinical Center of Kosovo. The study included 100 pregnant patients presenting with prelabour rupture of membranes of which 63 were primigravida and 37 patients were multigravida.RESULTS: The incidence of cesarean section in this study is 28 % and the most common indications for cesarean delivery were fetal distress, malpresentation, cephalopelvic disproportion, and failed induction. The most common maternal complications in this study are chorioamnionitis, retained placenta and postpartum hemorrhage. Neonatal infectious morbidity was present in 16 % of cases.CONCLUSION: PROM is a significant issue for obstetricians and an important cause of maternal and neonatal morbidity and increased rate of cesarean section delivery.


2021 ◽  
pp. 7-8
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients. Methodology: This was an observational study conducted at Department of Obstetrics and Gynaecology of Darbhanga Medical College and Hospital, Laheriasarai, Bihar. Aim of the study was to study the indication, maternal and fetal outcome in primary cesarean in multiparous women. All multiparous women admitted for delivery were included in the study Results: The total number of deliveries were 3064 and cesarean section were 1026 (33%).The total number of primary cesarean section in multiparous women were 84 constituting 2.7%. In this study, majority of women were Gravida 2. 91.6% of the cases were underwent emergency cesarean section and anesthesia was spinal. Majority of patients were between age group of 22 to 27 yrs (70%). Indications for cesarean section in our study were severe oligohydroamnios (22%), fetal distress (15.4%), and breech presentation (14%), premature rupture of membrane (12%).Intra operative ndings were meconium stained liquor, post partum hemorrhage, thinned out lower segment and extension of incision. Out of 84 cases, 48 cases needed intra operative or immediate post operative blood transfusion. The post operative morbidity was present in 6 cases i.e paralytic ileus, puerperal fever, urinary tract infection and wound gaping. Majority of babies, weighed in the range of 2-3kgs (55%).Out of 84 cases 7 were causes were placenta previa, obstructed labor and fetal distress. Conclusion: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.


2018 ◽  
Vol 6 (2) ◽  
pp. 781-784
Author(s):  
SAIMA PERVEEN ◽  
PARVEEN NAVEED ◽  
NAZISH HAYAT ◽  
NADIA RASHID

BACKGROUND: Perinatal outcome is related to the onset and duration of glucose intolerance. Theobjective of the study is to determine the effect of HbAlc on mode of delivery in Obs/Gynea departmentof Saidu Teaching Hospital, Swat.MATERIAL AND METHODS: This observational & descriptive study was carried out in theDepartment of Obstetrics and Gynecology at Saidu Teaching Hospital, Swat, from 1st March 2015 to29th Feb 2016. Total 313 pregnant women were included in the study, who had Gestational Diabetes orEstablished Diabetes.Detail history was taken regarding maternal age in years, gestational age in weeks.Abdominal examination was done for lie and presenting part of the fetus, and vaginal examination wereperformed. These patients were followed till the end of labour and their mode of delivery i-e; normalvaginal delivery, instrumental delivery or cesarean section was recorded. Maternal HbAlc level wasdone at the time of delivery and was categorized as Mild (< 6.5), Moderate (6.5-9) and severe (>9).Maternal HbAlc was measured in hospital laboratory. The numerical variables of mean HbAlc,maternal age in years and gestational age in weeks were analyzed by mean ± SD (range). Categoricalvariables like; grades of severity of HbAlc levels and frequency of modes of delivery were analyzed byfrequency (number) and relative frequency (percentages). SPSS 20 (SPSS Inc. Chicago, Illnios, USA)was used to analyze the data.RESULTS:The total number of patients was 313. Mean age of the study population was 27.85 ± 6.37(43 - 15) (95% Cl 28.39 - 27.30). The mean age of gestational amenorrhea, at which most of thepatients presented was 38.31 ± 3.02, ranging from 41 to 29, (95%CI 38.57 - 38.5). The meanglycosylated Hemoglobin (HbAlc) was 6.9 ± 1.69 (95% Cl 6.17 - 5.88). Majority of the patients hadpoorly controlled diabetes, i-e: 64%. In different levels of HbAlc levels, normal vaginal delivery wasthe pre dominant mode of delivery.CONCLUSION:^ patients with uncontrolled diabetes the rate of complications increased and so doesthe rate of macrosomia and fetal distress, leading to higher rate of cesarean section and instrumentaldelivery, so by strict control of the blood sugar levels in a diabetic patient one can reduce the risk ofoperative deliveries and complications.KEY WORDS:Hbalc levels, Mode of delivery, cesarean section


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