scholarly journals Efficacy and Safety of Vaginal Misoprostol for Cervical Ripening and Labour Induction in Late Pregnancy

KYAMC Journal ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 78-83
Author(s):  
Most Nasrin Nigger ◽  
Sheuly Akter ◽  
Ummul Nusrat Zahan ◽  
Fatema Begum
Keyword(s):  
Neonatal Intensive Care ◽  
Foley Catheter ◽  
Late Pregnancy ◽  
Meconium Aspiration Syndrome ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Efficacy And Safety ◽  
Group I ◽  
Catheter Group ◽  
Misoprostol Group

Background: Induction of labor is its intentional initiation before spontaneous onset, with the aim of vaginal birth which is safe for mother and newborn. The well documented effectiveness of misoprostol in several gynecological and obstetric applications has resulted in enthusiasm for its use. Objective: To see the efficacy and safety vaginal Misoprostal for cervical ripening and labour induction in late pregnancy. Materials and Methods: This single center clinical trial was carried out in the Department of Obstetrics and Gynaecology at Khwaja Yunus Ali Medical College and Hospital in Sirajgonj, Bangladesh from June 2019 to May 2020 for a period of one year. A total of 90 women requiring indicated induction of labour with an unfavourable cervix (Bishop score ≤ 4) were included in the study. They were randomly divided into two groups: 53 women induced with intravaginal misoprostol (Group I) and 37 women induced with transcervical Foley catheter (Group II). Results: Spontaneous vaginal delivery was 35(66.0%) in misoprostol group and 15(40.5%) in Foley catheter group. Caesarean section was higher in Foley catheter group than misoprostol group (37.8% vs 18.9%). The mean birth weight, APGAR score 1 minute, 5 minute, admission in neonatal intensive care unit and meconium aspiration syndrome were not statistically significant between two groups (p>0.05). Only one baby was died in Foley catheter group, but the difference was not statistically significant between two groups (p>0.05). Conclusion: The present study suggests intravaginal Misoprostol results in a shorter induction to delivery time, a reduction in the rate of caesarean delivery. KYAMC Journal.2021;12(02): 78-83

scholarly journals Postpartum Vaginal Blood Loss following Two Different Methods of Cervical Ripening

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Okon Asuquo Okon ◽  
John Egede Ekabua
Keyword(s):  
Blood Loss ◽  
Foley Catheter ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Treatment Groups ◽  
Catheter Group ◽  
Vaginal Deliveries ◽  
Misoprostol Group ◽  
The University ◽  
To Receive

Eighty women undergoing induction of labor at the University of Calabar Teaching Hospital were recruited and randomly allocated into two treatment groups (40 each), to receive either serial 50 µg doses of misoprostol or intracervical Foley catheter. Vaginal blood loss was collected and measured using an under buttocks plastic collection bag and by perineal pad weighing up to 6 hours postpartum. There were no significant differences between the two groups with respect to sociodemographic and obstetric characteristics. Comparison of blood loss in vaginal deliveries between the two groups revealed that subjects in the misoprostol group had significantly higher blood loss than subjects in the Foley catheter group (488 ± 222 versus 326 ± 106, p<0.05). In both groups, there was strong and statistically significant positive correlation between postpartum blood loss and induction delivery interval (r=0.75, p<0.0001; r=0.77, p<0.0001). There were no significant differences in maternal outcomes. In view of this, further study is required to ascertain if lower doses of misoprostol for induction of labor may result in lesser blood loss. This trial is registered with ISRCTN14479515.

scholarly journals Comparison of low dose vaginal misoprostol with Foley catheter balloon as preinduction cervical ripening agents in term pregnancies

2020 ◽  
Vol 1 ◽  
pp. 10
Author(s):  
Dalyop Davou Nyango ◽  
Daloek M ◽  
Kahansim ML
Keyword(s):  
Pregnant Women ◽  
Low Dose ◽  
Foley Catheter ◽  
Comparative Trial ◽  
Tertiary Hospital ◽  
Cervical Ripening ◽  
Catheter Group ◽  
Misoprostol Group ◽  
Uterine Hyperstimulation ◽  
Vaginal Misoprostol

Objective: One of the obstetricians’ nightmare is managing high-risk pregnancies. Also, the emerging trend by pregnant women requesting for specific delivery dates for social reasons adds to this burden. In both instances, the obstetrician is faced with the challenge of inducing labor where the cervix is still unfavorable. The objective of the study was to compare the effectiveness of loe dose vaginal misoprostol and transcervical extra-amniotic Foley catheter balloon as pre-induction cervical ripening agents in term pregnancies. Material and Methods: This was a prospective, single-blind, randomized comparative trial at a tertiary hospital. Pregnant women at term in whom induction of labor was indicated, who made the inclusion criteria and who gave their consent were randomly assigned to either the vaginal misoprostol or the Foley catheter balloon group. Oxytocin was used for the augmentation of labor subsequent to the artificial rupture of the membranes according to the departmental protocols. Results: One hundred and fifty women were recruited and randomized (75 in each group). In the misoprostol group, 58 (77.3%) women achieved cervical ripening (cervical dilation of ≥4) within 12 h, compared to 43 (57.3%) in the Foley catheter balloon group. Spontaneous vaginal delivery within 12 h was 88.0% and 66.3% in the misoprostol and Foley catheter group, respectively. However, 34.7% in misoprostol group had precipitate labor (induction-to-delivery interval ≤3 h), while 9.3% in the Foley catheter group had prolonged labor. There were no significant differences in the incidence of meconium staining and 1st min Apgar scores of the babies in the two groups. Conclusion: Low dose (25 μg) vaginal misoprostol is a more effective pre-induction cervical ripening agent compared to the conventional transcervical extra-amniotic Foley catheter balloon method. While uterine hyperstimulation is the major risk in the misoprostol group, long induction-to-delivery interval is associated with labors induced following use of Foley catheter balloon as the pre-induction cervical ripening agent.

scholarly journals Foley Catheter versus Vaginal Misoprostol for Labour Induction

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Nasreen Noor ◽  
Mehkat Ansari ◽  
S. Manazir Ali ◽  
Shazia Parveen
Keyword(s):  
Vaginal Delivery ◽  
Foley Catheter ◽  
Labour Induction ◽  
Sterile Saline ◽  
Group I ◽  
Catheter Group ◽  
Uterine Hyperstimulation ◽  
Spss Software ◽  
Vaginal Misoprostol ◽  
Foley’S Catheter

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.

scholarly journals A study comparing vaginal misoprostol alone with vaginal misoprostol in combination with Foley catheter for cervical ripening and labour induction

2017 ◽  
Vol 6 (2) ◽  
pp. 485 ◽  
Author(s):  
Binti R. Bhatiyani ◽  
Manisha R. Gandhewar ◽  
Swati Kapsikar ◽  
Pradip Gaikwad
Keyword(s):  
Foley Catheter ◽  
Active Phase ◽  
Fetal Distress ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Combination Group ◽  
Maternal Complications ◽  
Misoprostol Group ◽  
Vaginal Misoprostol

Background: Induction of labor is a commonly practised intervention in modern obstetrics. The objective of this study was to compare the efficacy of vaginal misoprostol alone with vaginal misoprostol in combination with Foley catheter for labour induction. It aims to assess the induction delivery interval, the outcome of labour, the incidence of instrumental delivery and Cesarean section. The neonatal outcomes and maternal complications would also be assessed.Methods: 105 women with singleton viable pregnancies of 28 weeks or more gestation with cephalic presentation, intact membranes and an unfavorable cervix (Bishops score less than 6) were randomly assigned to induction of labor using vaginal misoprostol or Foley catheter in combination with vaginal misoprostol. Women in the misoprostol only group received 25 micrograms of misoprostol per vagina every 4 hours for a maximum of six doses. Whereas women in the combination group received vaginal misoprostol and in addition Foley catheter was introduced through the cervix for 12 hours. Interruption of the trial was done in case of failure to enter the active phase of labour after 24 hours of induction, fetal distress, hyperstimulation, hypersensitivity to drugs.Results: The induction to delivery time was shorter in misoprostol group as compared to the Foley with misoprostol group by 3 hours. There was no significant change in Bishops score after induction with Foley in combination with misoprostol as compared to misoprostol alone. There was no increase in the maternal and fetal complications in the misoprostol group as compared to Foley with misoprostol.Conclusions: Misoprostol alone was more efficacious for ripening and inducing agent as compared to Foley in combination with misoprostol.

scholarly journals Efficacy of misoprostol over Foley’s catheter as a cervical ripening agent: a comparative study

2017 ◽  
Vol 6 (12) ◽  
pp. 5288
Author(s):  
Pankajkumar B. Nimbalkar ◽  
Jaldhara N. Patel ◽  
Nilesh Thakor
Keyword(s):  
Foley Catheter ◽  
Age Groups ◽  
Cervical Ripening ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Catheter Group ◽  
Misoprostol Group ◽  
Vaginal Misoprostol ◽  
Foley’S Catheter ◽  
Age Range

Background: Timely induction of labour could reduce maternal mortality and morbidity as well as assure a delivery of healthy baby. Objective of present study was to evaluate the efficacy of Misoprostol as a cervical ripening agent and its comparison with Foley’s catheter in terms of success rate, safety, side effects and patient compliance.Methods: A total of 250 pregnant women requiring induction of labor were recruited. Out of 250 cases, 150 were induced with 50 microgram Misoprostol and in 100 cases Foley catheter 18 F, was placed through the internal os of the cervix during September 2014 to August 2017 at the department of Obstetrics and Gynecology, GMERS Medical College, Dharpur-Patan. Written and informed consent was taken from the patients. Outcome measures, such as change in Bishop's score, need of augmentation, induction delivery interval; complications like hyperstimulation, fever and meconium passage were compared between two groups. Statistical analysis was performed by Epi Info 7.Results: Age range of the patients was 21 to 35 years. 72.4 % of the patients were in 21-25 years age groups. 54.4% patients were multigravida. 59.2% patients had more than 37 weeks of pregnancy. 46.4% of the patients had premature rupture of membrane as indication of labour. The mean Bishop's score for induction was 3.21 in Misoprostol group. 81.3% patients in Misoprostol group and 88% of patients in Foley’s catheter group were delivered by vaginal delivery. 60 % patients delivered within 6 hours in Misoprostol group. (Misoprostol: 60%, Foley’s catheter: 9%, p<0.001) Incidence of thin meconium was 11.3% in Misoprostol group, 9 % in Foley’s catheter group. In Misoprostol group 3.3 women had fever after induction while it was 6% in Foley’s catheter group.Conclusions: The results of the present study confirm that vaginal misoprostol is more effective than Foleys catheter in pre-induction cervical ripening.

scholarly journals Intravaginal Misoprostol versus Transcervical Foley Catheter for Pre-Induction Cervical Ripening and their Outcome - A Comparative Study

2016 ◽  
Vol 27 (2) ◽  
pp. 72-78
Author(s):  
Sabiha Nazneen ◽  
Ferdousi Sultana ◽  
Kamrun Nahaer
Keyword(s):  
Caesarean Section Rate ◽  
Foley Catheter ◽  
Mode Of Delivery ◽  
Cervical Ripening ◽  
Socioeconomic Condition ◽  
Medical College ◽  
Catheter Group ◽  
Significant Difference ◽  
Misoprostol Group ◽  
Mean Time

Objective : To compare the efficacy of transcervical Foley Catheter and Intravaginal Misoprostol in pre-induction cervical ripeningMaterials & Methods : This crosssectional study was done in the inpatient dept. of obs. and gynae at the Rangpur Medical College and Hospital, Rangpur, Bangladesh between 1st July 2005 to 30th December, 2006. During 18 (eighteen) months of study period, 99 patients were enrolled, 50 were in group 1 where Misoprostol tablet was given vaginally and 49 were in group II where Foley Catheter was used transcervically. The Misoprostol tablet dosing regime was 50?g (one- fourth of a 200?g tablet), which was given vaginally (in the posterior vaginal fornix). The second dose was given after six hours. Though the maximum target was four doses that was 200?g, cervical ripening took place in all the cases with only two doses. Cervical scoring was reassessed after four hours in both the groups.Results: There were similar baseline characteristics such as age of the patients, socioeconomic condition etc. No significant difference was observed regarding parity, gravidity, gestational age, Bishop’s score and pre-induction of labour. There was also no significant difference in the mean time of pre-induction to delivery interval, mode of delivery and neonatal out come. Change in Bishop’s score was similar in both groups but more time was required from pre-induction to delivery in Foley catheter group. The most frequent complaint in Foley catheter group was mild discomfort at insertion. Vaginal delivery was higher in this group (63.3%) whereas Caesarean section rate was higher in Misoprostol group (36%) due to hyperstimulation syndrome.Conclusion: Both intravaginal Misoprostol and transcervical Foley catheter have similar effectiveness as pre-induction agents in unripe cervix. Transcervical Foley catheter is associated with a lower incidence of hyperstimulation syndrome (presence of hypertonous utrine contraction associated with abnormal foetal heart rate) and higher incidence of vaginal deliveries.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 72-78

scholarly journals Comparative study of vaginal misoprostol and intra cervical Foley’s catheter for pre-induction cervical ripening at term

2017 ◽  
Vol 6 (4) ◽  
pp. 1283
Author(s):  
Meghna Agarwal ◽  
Varsha Kose
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Foley Catheter ◽  
Cervical Ripening ◽  
Catheter Group ◽  
Misoprostol Group ◽  
Group 2 ◽  
Vaginal Misoprostol ◽  
Foley’S Catheter ◽  
Group 1

Background: At times of unfavorable cervix induction of labor with cervical ripening agents were necessary. The present study was done to compare the efficacy and outcome of vaginal misoprostol and Foleys catheter in pregnant women for induction of labor.Methods: This randomized clinical trial was performed on 10o pregnant women during a time period of December 2014 to November 2016. These women were randomly divided into two groups: Misoprostol (50 patients) and Foley catheter (50 patients). For the first group, 25 mcg vaginal misoprostol was administered every 4 h up to maximum of 3 doses for a period of 12 hours. For the second group, Foley catheter 18 F, was placed through the internal os of the cervix. Data was analyzed using SPSS software 20. p <0.05 was considered statistically significant.Results: The mean age of the patients in Group 1 was 24.72±2.93 years and Group 2 was 24.12±2.88 years. Pre-induction & post-induction modified Bishop score was significantly higher in Group 1 (Misoprostol) as compared to Group 2 (Foley's catheter) in primigravida and multigravida patients. The difference in the birth weight and Apgar score at 1 min and 5 min between the two groups was statistically not significant (p>0.05). The rate of vaginal delivery was significantly more in Misoprostol group as compared to Foley’s catheter group (p<0.05). The caesarean section rate was more in Foley’s catheter group as compared to Misoprostol group and the results were statistically significant (p<0.05).Conclusions: It was concluded that misoprostol decrease the delivery time and increases the vaginal delivery compared to Foleys catheter.

scholarly journals A Comparison of Orally Administered Misoprostol With Vaginally Administered Misoprostol For Cervical Ripening And Labour Induction

KYAMC Journal ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 668-672 ◽  
Author(s):  
Sohana Siddique ◽  
Muhammad Jahangir Howlader ◽  
Joysree Saha ◽  
Kazi Shahnaz Begum
Keyword(s):  
Mode Of Delivery ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Efficacy And Safety ◽  
Cross Sectional ◽  
Oral Misoprostol ◽  
Number Of Patients ◽  
Oral Group ◽  
Vaginal Misoprostol ◽  
Duration Of Pregnancy

Objective: To compare efficacy and safety of oral misoprostol over vaginal misoprostol for labour induction.Materials and Methods: This is a cross sectional interventional hospital based comparative study which was carried in the department of Obstetrics and Gynecology in DMCH from 01.07.2008 to 31.12.2008.Results: Almost equal number of patients delivered vaginally spontaneously in both group, there is no association between route of administration and mode of delivery. Nausea,vomiting occurred more in oral group and uterine hypertonicity more in vaginal group.Conclusion: In this study, 50 patients were randomly selected for oral group and 50 patients for vaginal group. There were no significant differences regarding age, duration of pregnancy, Bishop's score and indication of induction of labour.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 668-672

scholarly journals A comparative study of intra-cervical foley’s catheter and PGE2 gel for induction of labour at term

2019 ◽  
Vol 8 (9) ◽  
pp. 3689
Author(s):  
Anjali R. Kanada ◽  
Mahima Jain
Keyword(s):  
Side Effects ◽  
Caesarean Section ◽  
Comparative Study ◽  
Foley Catheter ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Mechanical Methods ◽  
Significant Difference ◽  
Foley’S Catheter

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.

Methods for cervical ripening and labour induction in late pregnancy: generic protocol

2009 ◽  
Author(s):  
G Justus Hofmeyr ◽  
Zarko Alfirevic ◽  
Anthony J Kelly ◽  
Josephine Kavanagh ◽  
Jane Thomas ◽  
...  
Keyword(s):  
Late Pregnancy ◽  
Cervical Ripening ◽  
Labour Induction
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