scholarly journals Clinical Outcome Following Induction of Labour with Misoprostol

2017 ◽  
Vol 6 (2) ◽  
pp. 49-52
Author(s):  
Serajoom Munira ◽  
Fatema Begum ◽  
Farhana Dewan ◽  
Sadia Mahfiza Khanam ◽  
Aftabun Nahar ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Perinatal Death ◽  
Fetal Distress ◽  
Maternal Outcome ◽  
Induction Of Labour ◽  
Maternal Distress ◽  
Normal Vaginal Delivery ◽  
Perineal Tear ◽  
Oral Misoprostol

Background: Induction of labour in the third trimester of pregnancy may be considered beneficial in many clinical circumstances.Objective: The aim of this study was to find the effectiveness and safety of a novel dosing regimen of oral misoprostol in a Bangladeshi sample.Methods: A cross sectional study was conducted in the Department of Obstetrics and Gynecology, Sir Salimullah Medical College & Mitford Hospital, Dhaka from October 2008 to September 2009 based on the guideline of American College of Obstetricians and Gynecologists. Fifty nine cases were enrolled according to inclusion criteria by clinical pelvimetry and bishop scoring. Contracted pelvis, evidence of cephalopelvic disproportion, placenta previa, unexplained vaginal bleeding, grand multipara, fetal malpresentation, previous uterine scar and fetal distress cases were excluded. Misoprostol was administered per orally. Maternal outcome was assessed by normal vaginal delivery, caesarean section, maternal distress, perineal tear, cervical tear, uterine hyper-stimulation and fetal outcome was assessed in the form of fetal distress, meconium stained amnions, neonatal admission, perinatal death and no complication. Statistical analysis was done using SPSS v 13. Probability value was set at P<0.05 for statistical significance.Results: Mean age was 25.69(5.04) years and mean age of gestation was 38.23(4.3) weeks and 59% were in regular antenatal checkup. Misoprostol was administered orally, 15% single, 37% double, 34% three and l4% were more than three doses. Following induction, 85% had normal vaginal delivery, 10% caesarean section and 5% had forceps delivery. For induction, 56% were due to preeclampsia, eclampsia & other pregnancy induced hypertension, 10% postdated pregnancy, 9% were unfavorable cervix, 7% IUD, l4% elective cases due to medical disorder, 2% had premature rupture of membrane, other causes were 3%. By bishop score assessment 54% had unfavorable and 46% had favorable cervix. In neonate's outcome, 34% had no complications, 19% meconium stained, 19% neonatal admission, 9% fetal distress and 20% had perinatal death including IUD. In maternal outcome, 69% no complications, 10% perineal tear, 10% caesarean section, 3% maternal distress, 3% cervical tear, 2% uterine hyper-stimulation, 2% episiotomy. There were no significant differences.Conclusions: Stepwise oral misoprostol was well tolerated with no increase in maternal side effects. There was also a trend towards more fetal safety in the oral misoprostol. Perhaps the most significant finding of our study is the lower cesarean section rate in the women who received the oral regimen.J Shaheed Suhrawardy Med Coll, 2014; 6(2):49-52

scholarly journals OASIS: clinical audit in a tertiary care centre

2018 ◽  
Vol 7 (5) ◽  
pp. 1958
Author(s):  
Sruthy Soman ◽  
Sobha S. Nair ◽  
Janani J. N. ◽  
Radhamany K. ◽  
Ann John Kurien
Keyword(s):  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Gestational Age ◽  
Rectal Mucosa ◽  
Shoulder Dystocia ◽  
Induction Of Labour ◽  
Normal Vaginal Delivery ◽  
Perineal Tear ◽  
Vertex Presentation

Background: Obstetric anal sphincter injury involves injury to the anal sphincter and rectal mucosa sustained at time of vaginal delivery and can result in significant long-term morbidity. These injuries have been defined as 3rd and 4th degree lacerations that involve disruption of the anal sphincter and rectal mucosa respectively. Objectives of this study were to find out the incidence of obstetrical anal sphincter injuries, to identify the risk factors for of OASIS and the outcome of primary repair in terms of anal incontinence and its associated complications.Methods: We did a descriptive study of OASIS by retrospective analysis of the labour case records. The study period was 1 year between August 2016 to July 2017. Inclusion criteria were singleton pregnancy, vertex presentation, instrumental and normal vaginal delivery. Exclusion criteria were multiple pregnancy, non-vertex presentation and caesarean section. Proforma was developed to capture the age, parity, gestational age in weeks, induction of labour, epidural analgesia, delivery duration, type of episiotomy, instrumentation, shoulder dystocia, occipito posterior position,manual support, weight of the baby, suturing method. Postnatal evaluation after 6 weeks and 6 months for perineal discomfort, pain, incontinence, wound infection, breakdown, fistula were noted. Results: The incidence of OASIS was 1.4%. 81.8% women had 3rd degree perineal and 18.1% had 4th degree perineal tear. The mean age of the patients were 27.9 years, gestational age of 39.45 weeks, 72.7% were primiparous. Induction of labour with prostaglandins was done in 36.36% and Pitocin augmentation for 81.81%. The duration of second 36.36% had 60-89 min and 27.27% had duration more than 90 min. 54.54% had epidural analgesia, 36.36% had shoulder dystocia, 36.36% had instrumental delivery. 72.72% babies had birth weight between 3-3.5 kg, 9% between 3.5-4 kg. Ano vaginal fistula developed in 9%.Conclusions: Appropriate training, anticipating and identifying major degrees of perineal tear helps in reducing the complications. Anovaginal fistula is distressing and disabling the patient and to her near ones.

Incidence of cesarean delivery after induction of labour with dinoprostone gel at term in nulliparous women with unfavourable bishops score

2017 ◽  
Vol 6 (4) ◽  
pp. 1253
Author(s):  
Kalpana Mehta ◽  
Dhanesh Kumar ◽  
Dharmendra Singh Fathepuriya ◽  
Leena Verma
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Previous History ◽  
Fetal Distress ◽  
Induction Of Labour ◽  
Normal Vaginal Delivery ◽  
Bishop Score ◽  
Nulliparous Women ◽  
History Of ◽  
The Mean

Background: The aim of induction of labour is to achieve vaginal delivery in advance of the normal timing of parturition and to avoid operative delivery. The objective was to study the incidence of instrumental delivery and cesarean section in nulliparous women with unfavourable bishops score at term.Methods: This study was conducted on 200 patients in nulliparous women with unfavourable bishop score, cephalic presentation and no previous history of abortion.Results: The most frequent cause of induction of labour was postdatism (47.5%) followed by PIH (25.5%) and PROM (13%). 143 (71.5%) women had normal vaginal delivery whereas in 54 women (27%) cesarean section was done. 2 women (1%) had forceps application for delivery and remaining 1 women (0.5%) had ventouse delivery. Out of 200 patients 9 had maternal complication of induction of labour.Conclusions: In present study 71.5% women had normal vaginal delivery, 27% had cesarean section. Mean bishop score at induction was 3.31 which improved to 4.0 after 12 hours of gel instillation. The mean induction to delivery interval was 13.38 hrs in present study, 54.5% patients were delivered within 12 hours of gel instillation in this study. Most common indication of cesarean section was failed progress followed by fetal distress.

scholarly journals Study of primary caesarean section in multigravida patients

2017 ◽  
Vol 7 (1) ◽  
pp. 185
Author(s):  
Neelam Rajput ◽  
Priyanka Singh ◽  
Yogendra Singh Verma
Keyword(s):  
Caesarean Section ◽  
Neonatal Mortality ◽  
Vaginal Delivery ◽  
Low Socioeconomic Status ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Major Surgery ◽  
Medical Disorders ◽  
Number Of Patients

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.Methods: It was a prospective study of primary caesarean section in multigravida admitted at Kamla Raja Hospital, G.R. Medical College and J. A. Group of Hospitals, Gwalior (Madhya Pradesh, India) during the period of 1 year from September 2014 to August 2015. Multigravida with pregnancy of >28 weeks gestation (gravida 2 and above), each of whom has had a previous vaginal delivery of > 20 weeks gestation were included. Women with previous abortions and previous section and Pregnancy with medical disorders were excluded.Results: During the study period of one year, total 8185 deliveries occurred, out of which 3061 (37.39%) underwent caesarean section and 386 (12.61%) were primary caesarean section in multigravida. Out of these multigravida patients who underwent primary caesarean section- most of the patients were unbooked (77.72%). Majority of the cases were direct admission in the hospital (61.13%). Maximum number of the patients were in the age group of 25-30 years (55.95%). Two third of the patients were literate (69.44%) Maximum number of patients were Gravida 2 (49.72%). Almost all of them (95.85%) underwent emergency caesarean section. The most common indication for primary LSCS in multigravida patients was Malpresentation 115 (29.79%) followed by Fetal distress in 71 (18.39%) patients, APH in 71 (18.39%), Obstructed labour in 33 (8.55%), Severe preeclampsia and Antepartum eclampsia in 39 (10.1%), Twin pregnancy in 21 (5.44%). Most common maternal complication was pyrexia 40 (10.36%). Postoperative morbidity was 21.24% among unbooked, 14.25% in Referred, 23.58% in those operated as an emergency, 12.43% in patients belonging to of low socioeconomic status and 3.88%, in patients with moderate to severe anemia. Birth asphyxia was found in 6.21% of neonates. Neonatal mortality was 2.33%. Neonatal mortality is more in Unbooked cases (90.47%).Conclusions: 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.

scholarly journals Outcome Of Induction Of Labour By Intravaginal Prostaglandin Versus Intravenous Oxytocin In a Tertiary Care Hospital

2012 ◽  
Vol 17 (2) ◽  
pp. 30-33
Author(s):  
Mst Shahana Pervin ◽  
Shamima Haque ◽  
Jahanara Rahman
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Cost Effective ◽  
Induction Of Labour ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Maternal Complications ◽  
National Medical ◽  
Unfavorable Cervix

Aim of the study was to determine the effectiveness and safety of intravaginal misoprostol VS intravenous oxytocin in induction of labour and to compare the induction delivery interval between prostaglandin induction and oxytocin induction and to detect maternal and foetal outcome between prostaglandin induction and oxytocin induction and also reduce the rate of caesarean section . A prospective, randomized trial was carried out in one hundred singleton pregnant women admitted in Dhaka National Medical Hospital during the period of January 2006 to December 2006. Women who had unfavorable cervix (Bishop’s score<) were selected. 50 of them received 50 mgm misoprostol intravaginally for three doses, 6 hourly. Another 50 patient received intravenous starting from 10 mU /ml up to 40mU.Thirty-nine patients out of 50 patients of misoprostol group achieved normal vaginal delivery. Rest eleven patients ended by caesarean section. 82% of this group delivered within 10 hours. The maximum required dose was 50-150mgm. Maternal complications were PPH 2%. Neonatal outcome were satisfactory. Thirty – six patients out of 50 patients of Oxytocin group achieved normal vaginal delivery. Rest fourteen patients ended by caesarean section. Only 66% of this group delivered within 10 hours. The maximum required dose was 40mU/ml. From the study it was found that intravaginal misoprostol is well tolerated and very effect then intravenous oxytocin in induction of labour in unfavorable cervix. It certainly reduces the number of caesarean section. It is cost effective. DOI: http://dx.doi.org/10.3329/jdnmch.v17i2.12213 J. Dhaka National Med. Coll. Hos. 2011; 17 (02): 30-33

scholarly journals On demand caesarean section: What’s women’s attitude?

1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
University Teaching ◽  
Normal Vaginal Delivery ◽  
On Demand ◽  
Assisted Delivery ◽  
The Right

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15

scholarly journals Postpartum quality of life after normal vaginal delivery and caesarean section

2015 ◽  
Vol 2 (2) ◽  
pp. 13-18
Author(s):  
Yogendra Amatya ◽  
Samita Acharya
Keyword(s):  
Quality Of Life ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Elective Caesarean Section ◽  
Family Type ◽  
Normal Vaginal Delivery ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Physical Health Composite Score

Introductions: Caesarean section is rising. The best method of delivery, vaginal or caesarean, for postpartum quality of life in women is a matter of controversy both from professionals’ perspectives and from women’s experience of childbirth. This study analyses quality of life after these two methods of deliveries.Methods: This was a cross-sectional comparative study in postnatal care outpatient department at Patan Hospital. Primipara women with normal delivery and elective caesarean section done in Patan Hospital were enrolled to analyse postpartum quality of life. The SF-12 questionnaire tool at 6 weeks post delivery was used to compare age, ethnicity, education, family type and employment. Data was analysed using ANOVA test for descriptive parameters.Results: There were 468 primipara, age 30-45 years, 94% in 15-30 years77.8% educated, 74.4% in joint family,73.5% housewife. Normal vaginal delivery was 360 (72.6%) and 128 (27.4%) elective caesarean. Vaginal delivery group had average SF score of Physical Health Composite Score of 68.7, Mental Health CompositeScore69.5 and total SF score 67.7. While in caesarean group, it was 64.8,64.1 and 63.4.Conclusions: Normal vaginal delivery had better quality of life resulting in both superior physical as well as mental health.Journal of Patan Academy of Health Sciences, Vol. 2, No. 2, 2015. page:13-18

scholarly journals A Comparative Study to Assess the Level of Anxiety among Primi Gravida Mothers Planned for Normal Vaginal Delivery and Caesarean Section in the Selected Hospital, Agartala, West Tripura

2021 ◽  
Vol 6 (2) ◽  
pp. 58-61
Author(s):  
Ishita Nath
Keyword(s):  
Caesarean Section ◽  
Comparative Study ◽  
Vaginal Delivery ◽  
Demographic Variable ◽  
Demographic Data ◽  
Sampling Technique ◽  
Normal Vaginal Delivery ◽  
Research Approach ◽  
Perinatal Anxiety ◽  
Anxiety Screening

A comparative study was conducted among 100 primi gravida mothers (50 mothers in each group) from MCH clinic and IPD of IGM hospital, Agartala, West Tripura, who had planned for normal vaginal delivery and caesarean section. Research approach used was non experimental quantitative approach and research design was descriptive comparative design. Purposive sampling technique was used to draw the sample. Socio demographic data and modified Perinatal Anxiety Screening Scale were used to collect data from the samples through interview method. Analysis revealed that 52% of the primi gravida who had planned for caesarean section and 44% mothers who had planned for normal vaginal delivery had mild symptoms of anxiety. Mean anxiety score of the mothers who planned for caesarean section and normal vaginal delivery was 27.3 and 19.7 respectively, median 28.855 and 18.915 respectively and SD 7.0715 and 8.038 respectively. The mean difference was 7.6 and unpaired ‘t’ value was 5.0198, which was significant at p<0.05. Analysis of variance result showed that there was significant association between the level of anxiety of the primi gravida mothers who had planned for caesarean section with their selected socio demographic variable ‘occupation of husband’. The calculated ‘F’ value was 3.33 at p<0.05. The researcher concluded that the primi gravida mothers who had planned for caesarean section had more anxiety than the mothers who had planned for normal vaginal delivery and the anxiety level of the mothers who had planned for caesarean section was dependent on selected demographic variable occupation of the husband. Keywords:Anxiety, primi gravida, normal vaginal delivery, caesarean section.

CLINICAL STUDY OF PRIMARY CESAREAN SECTION IN MULTIPAROUS WOMEN AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2021 ◽  
pp. 7-8
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Major Surgery ◽  
Obstetrics And Gynaecology ◽  
Emergency Cesarean ◽  
Study Results ◽  
Multiparous Women

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.

scholarly journals Amniotic fluid index versus maximum vertical pocket measurement in predicting perinatal outcome at 40 weeks or beyond

2018 ◽  
Vol 7 (12) ◽  
pp. 4887
Author(s):  
Nasreen Noor ◽  
Seema Amjad Raza ◽  
Shazia Parveen ◽  
Mohammad Khalid ◽  
Syed Manazir Ali
Keyword(s):  
Amniotic Fluid ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Prospective Observational Study ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Amniotic Fluid Index ◽  
Institutional Ethics ◽  
Significant Difference ◽  
Baseline Demographic

Background: The aim of this study is to compare the use of amniotic fluid index with maximum vertical pocket for predicting perinatal outcomes.Methods: The present study was a prospective observational study and includes 140 The study include normal antenatal women at gestational age 40 weeks or beyond (by last menstrual period/1st trimester scan) referred from antenatal between 20 to 40 years were enrolled in this study from 2015 to 2017. After Institutional Ethics Committee approval all recruited women was assessed at the 3rd trimester visit for baseline demographic and obstetric data. After taking a detailed history and examination the women were subjected to ultrasonography for Amniotic Fluid index (AFI) and Maximum vertical pocket (MVP). The women were divided into 2 groups based on measurement of AFI and MVP ultrasonologically. The correlation of Amniotic fluid index and Maximum vertical pocket with perinatal outcome were computed for the 2 groups: Group Ia - women having normal AFI and normal MVP; Group Ib - women having decreased AFI and normal MVP.Results: In Group Ia, 31(34.44%) women were induced and in Group Ib 59 (65.56%) women were induced for oligohydramnios. 65 women (72.22%) had normal vaginal delivery versus 25women (27.28%) had undergone LSCS in Group Ia, while in Group Ib, 32 women (64%) versus 18 women (36%) had vaginal delivery and LSCS respectively. Higher rate of LSCS was observed in Group Ib. There was no significant difference in the rate of LSCS for fetal distress between Group Ia and Ib for fetal distress.Conclusions: Amniotic fluid index (AFI) compared with the maximum vertical pocket (MVP) excessively characterizes patients as having oligohydramnios, leading to an increase in obstetric interventions, without any documented improvement in perinatal morbidity and mortality. Thus, authors cannot find any objective reason to favour AFI over MVP.

scholarly journals Evaluation of induction of labour in a tertiary care hospital

2020 ◽  
Vol 9 (4) ◽  
pp. 1361
Author(s):  
Janupalli Kiran Poornima ◽  
Vijayalakshmi K. ◽  
Anuradha C. R. ◽  
Famida . ◽  
Sai Latha R.
Keyword(s):  
Vaginal Delivery ◽  
Apgar Score ◽  
Induction Of Labour ◽  
Delivery Rate ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Normal Delivery ◽  
Operative Vaginal Delivery ◽  
Misoprostol Group ◽  
Oxytocin Augmentation

Background: The objective is to evaluate the preferred methods for labor induction, including incidence of caesarean section, operative and normal vaginal delivery rate, need for oxytocin augmentation, and Apgar score at 1 and 5 min.Methods: This was a hospital-based study carried out in 110 inductions of labour during the study period. misoprostol 50 mcg was inserted in posterior fornix of vaginal in cases with PROM and intracervical 0.5 mg Dinoprostone for other causes in whom induction was decided. Maternal and neonatal outcomes were observed. collected data were analyzed using SPSS and MS excel.Results: Most preferred methods of induction of labour were observed to be Dinoprostone and Misoprostol, augmentation was done by oxytocin. normal delivery rate was 54% in Dinoprostone gel and 58.3% in misoprostol group. Caesarean and operative vaginal delivery rates were 42.8%, 3% in Dinoprostone gel group and 33.3%, 8.3% respectively in misoprostol group. Mean Apgar scores were observed to be similar in both methods of induction at 1st and 5th minutes.Conclusions: It was found that misoprostol had higher percentage of normal and operative vaginal delivery and need for oxytocin augmentation than Dinoprostone. Neonatal outcome as predicted by Apgar score were similar in both groups.

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