Faculty Opinions recommendation of Misoprostol compared with prostaglandin E2 for labour induction in women at term with intact membranes and unfavourable cervix: a systematic review.

AbstractInduction of labour (IOL) is increasingly used in obstetric practice. For patients with unfavourable cervix, we are constantly looking for an optimal, in terms of effectiveness and safety, ripening of cervix protocol. It was retrospective cohort study. We analyzed obstetrical results in 481 patients undergoing IOL in one center using two different vaginal inserts that release prostaglandins at a constant rate for 24 h—misoprostol vaginal insert (MVI) with 200 µg of misoprostol (n = 367) and dinoprostone vaginal insert (DVI) with 10 mg of dinoprostone (n = 114). Full-term, single pregnancy patients with intact fetal membranes and the cervix evaluated in Bishop score ≤ 6 were included in the analysis. In the group of MVI patients, the labour ended with caesarean section more often (OR 2.71 95% CI 1.63–4.47) and more frequent unreassuring cardiotocographic trace indicating the surgical delivery occurred (OR 2.38 95% CI 1.10–5.17). We did not notice any differences in the percentage of vacuum extraction and patients in whom the use of oxytocin was necessary during labour induction. The clinical status of newborns after birth and the pH of cord blood did not differ between groups.The use of MVI 200 μg in patients with an unriped cervix is associated with a greater chance of completing delivery by caesarean section and increased chance of abnormal intrapartum CTG trace compared to the use of DVI 10 mg. These differences do not affect the clinical and biochemical status of the newborn.

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Evaluation of pre induction scoring by clinical examination vs transvaginal sonography

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20164664 ◽

2016 ◽

Vol 6 (1) ◽

pp. 228

Author(s):

Sonali Kaur Sharma ◽

Madhu Nagpal ◽

CL Thukral

Keyword(s):

Vaginal Delivery ◽

Transvaginal Ultrasound ◽

Cervical Length ◽

Induction Of Labour ◽

Labour Induction ◽

Transvaginal Sonography ◽

Bishop Score ◽

Unfavourable Cervix ◽

Successful Induction ◽

Singleton Pregnancies

Background: The aim of the study was to find out pre-induction cervical length by TV Sonography, determine Bishops score and to co-relate the obstetric outcome with these two variables.Methods: A study was done on 100 women with singleton pregnancies at 37-42 weeks of gestation, admitted for induction of labour in the Department of Obstetrics and Gynaecology at SGRDIMSR, Vallah, Amritsar, Punjab, India. All women underwent cervical assessment by both transvaginal ultrasound and Bishop Score and the outcome of labour induction was determined.Results: Of the 100 women, 53 women had vaginal delivery and 47 landed into LSCS. Bishop score < 6 and cervical length > 3 cm are cut off values of cervical unfavourablity. Successful induction was achieved among 87.5% and 78% women with favorable cervix according to Bishop Score and Cervical length respectively .Among the 92 and 50 women with unfavourable cervix according to Bishop score and cervical length, 48 (52.17%) and 14 (28%) had vaginal delivery respectively.Conclusions: Hence, cervical length by transvaginal ultrasound is a better predictor for the success of induction of labour as compared with assessment by Bishop Score alone.

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Use of Misoprostol in Pregnancy- A Review Article

Medicine Today ◽

10.3329/medtoday.v22i2.12443 ◽

2012 ◽

Vol 22 (2) ◽

pp. 94-98

Author(s):

Syeda Ummay Kulsum ◽

Sabera Khatun ◽

SM Shahnawaz Bin Tabib

Keyword(s):

Prostaglandin E2 ◽

Review Article ◽

Induction Of Labour ◽

Cervical Ripening ◽

Labour Induction ◽

Pharmacological Agents ◽

Tablet Form ◽

Cytoprotective Agent ◽

Medicine Today

Prostaglandins are the pharmacological agents used for induction of labour and augmentation of labour. Prostaglandin E2 gel is used for cervical ripening and induction of labour. These are however, costly and need to be stored in a refrigerator at a temperature of 2 - 8°C, half life 18 months. The Tablet form of prostaglandin E2 is not available in Bangladesh. Misoprostol, a synthetic prostaglandin (PG) E1 analogue is used orally for the treatment of gastric and duodenal ulcer and used as a cytoprotective agent. It was first used for labour induction in 1987. Prostaglandin can be used in several gynaecological and obstetric conditions. It can be given through several routes. This article will elaborately delinate the role of misoprostol, a prostaglandin in obstetrics and gynaecological conditions. Medicine Today 2010 Volume 22 Number 02 Page 94-98 DOI: http://dx.doi.org/10.3329/medtoday.v22i2.12443

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