scholarly journals Low Dose Vaginal Misoprostol in the Management of Women with Intrauterine Fetal Death

2010 ◽  
Vol 3 ◽  
pp. CMWH.S5797
Author(s):  
M.N. El-Gharib ◽  
M.T. El-Ebyary ◽  
T.S. Alhawary ◽  
S.H. Elshourbagy
Keyword(s):  
Fetal Death ◽  
Mean Value ◽  
University Hospital ◽  
Intrauterine Fetal Death ◽  
Third Trimester ◽  
Trimester Pregnancy ◽  
Observational Cohort ◽  
The Mean ◽  
Vaginal Misoprostol ◽  
Duration Of Gestation

Objectives The study was conducted to assess the effectiveness and side effects of vaginal misoprostol (Vagiprost® tablet) in termination of second and third trimester pregnancy complicated with intrauterine fetal death. Design A prospective observational cohort study. Setting Tanta University Hospital. Patients The study was carried out on 324 women with fetal demise in the second and third trimesters. Cases were collected during the period from January 2008 to December 2009. Intervention All patients were subjected to history taking, physical examination, Bishop Scoring. Application of 25 μg misoprostol in the posterior fornix of the vagina, this will be repeated every 4 hours over 24 hours. The adverse effects, progress, and outcomes were assessed. Results the success rate was 90% and 45% in women with third and second trimesters respectively. The mean induction-termination interval was 8.95 ± 2.63 and 15.3 ± 5.37 hours for women with third and second trimesters respectively. The induction termination interval correlated negatively with the duration of gestation. Approximately, 90% of second trimester and 55% of third trimester women required oxytocin augmentation. The mean value of total required dose of misoprostol was 166.3 ± 7.5 and 120 ± 28.79 μg for women with second and third trimesters respectively. Conclusion Vagiprost appears to be a safe, effective, practical, and inexpensive method for termination of third trimester pregnancy complicated with of intrauterine fetal death (IUFD), its effects increase with parity and duration of gestation.

scholarly journals A prospective clinical study of management of pregnancy complicated with intauterine fetal death by low dose prostaglandins

2017 ◽  
Vol 6 (9) ◽  
pp. 3788
Author(s):  
Nandkishor Vithalrao More ◽  
Bhaurao Bhimrao Yadav ◽  
Mangla Ashok Shinde
Keyword(s):  
Low Dose ◽  
Fetal Death ◽  
Mean Value ◽  
Prospective Clinical Study ◽  
Third Trimester ◽  
Medical College ◽  
Posterior Fornix ◽  
The Mean ◽  
Vaginal Misoprostol ◽  
Duration Of Gestation

Background: This study was conducted to evaluate the effectiveness and side effects of Prostaglandins (vaginal misoprostol) in the termination of second and third trimester pregnancies complicated with intrauterine fetal death.Methods: This study was carried out on 100 women with intrauterine fetal demise in second and third trimester pregnancies collected from Government Medical college and Hospital during the period October 2014 to October 2016.Results: By the application of 25µg of misoprostol in the posterior fornix of vagina every 4 hourly over 24 hours. The progress, adverse effects and outcomes were assesed. The success rate was 92.76% and 64.52% in women with third and second trimesters respectively. The mean induction delivery interval was 15.67±9.64 and 24.94±8.23 for women with third and second trimesters respectively. The induction delivery interval correlated negatively with the duration of gestation. The mean value of total required dose was 192.42±128.99 and 361.29±139.92 for women with third and second trimesters respectively.Conclusions: Low dose misoprostol appears to be safe, effective, practical and inexpensive method for termination of third trimester pregnancies compared to second trimester complicated with intauterine fetal death and its effects increases with duration of gestation.

scholarly journals Comparative Study of Management of Intrauterine Fetal Death by Misoprostol versus Oxytocin

2020 ◽  
Vol 9 (1-2) ◽  
pp. 74-79
Author(s):  
Lipika Ghosh ◽  
Fatema Binta Islam ◽  
Farjana Maksurat ◽  
Mamata Manjari ◽  
Rowshan Afrooz
Keyword(s):  
Fetal Death ◽  
Induction Of Labor ◽  
Termination Of Pregnancy ◽  
Intrauterine Fetal Death ◽  
Oxytocin Infusion ◽  
Misoprostol Group ◽  
The Mean ◽  
Vaginal Misoprostol ◽  
Time Required ◽  
Mean Time

Background & objective: Management of pregnancy with intrauterine fetal death (IUFD) is always puzzling to the obstetricians and mental agony to the patients. Intravenous oxytocin infusion was previously practiced for termination of pregnancy with IUFD. But recently misoprostol is claimed to be better than oxytocin in terms of its efficacy and safety. This prospective study was carried out to find which of these two drugs is suitable for termination of pregnancy with IUFD. Methods: Based on predefined criteria,a total of 100 singleton pregnant women with gestational age more than 22 weeks, ultrasonographically confirmed as having dead fetus in utero were included in the study and were randomly assigned to vaginal Misoprostol and Oxytocin infusion groups. The outcome was evaluated in terms of time required for induction of labor, induction to delivery time and complications encountered by each group. Result: The overall time required for induction to delivery was significantly shorter in Misoprostol group than that in Oxytocin group irrespective of their Bishop’s score (p < 0.001). Even in patients in whom the cervix was unripe (Bishop's score < 6), the mean time required from induction to delivery was much shorter in Misoprostol group (p < 0.001), but in patients in whom the cervix was ripen, the mean time from induction to delivery in Misoprostol group was shorter, but the difference did not turn to significant (p = 0.079). Both nulliparous and multiparous women experienced significantly shorter durations of labor in the Misoprostol group than those in the Oxytocin group (p < 0.001 and p = 0.001 respectively). Complications like hyperstimulation, retained placenta and postpartum hemorrhage all were somewhat higher in Misoprostol group than those in Oxytocin group, but the differences were not statistically significant (p = 0.357, p = 0.500 and p = 0.500 respectively). Conclusion: The use of vaginal misoprostol is more effective than intravenous infusion of oxytocin in induction of labor in patients with IUFD. The time required from induction to delivery is appreciably shorter when Misoprostol is used compared to that needed when oxytocin is used. Ibrahim Card Med J 2019; 9 (1&2): 74-79

Correlations Between the Values of Maternal Glycemia from the Last Trimester of Pregnancy and Fetal Birth Weight

2013 ◽  
Vol 20 (3) ◽  
pp. 259-265
Author(s):  
Monica Vereş ◽  
Aurel Babeş ◽  
Szidonia Lacziko
Keyword(s):  
First Trimester ◽  
Mean Value ◽  
Fetal Macrosomia ◽  
Entire Group ◽  
Third Trimester ◽  
The Third ◽  
Group I ◽  
Fetal Birth Weight ◽  
First Trimester Of Pregnancy ◽  
The Mean

Abstract Background and aims: Gestational diabetes represents a form of diabetes diagnosed during pregnancy that is not clearly overt diabetes. In the last trimester of gestation the growth of fetoplacental unit takes place, thus maternal hyperglycemia will determine an increased transplacental passage, hyperinsulinemia and fetal macrosomia. The aim of our study was that o analyzing the effect of maternal glycemia from the last trimester of pregnancy over fetal weight. Material and method: We run an observational study on a group of 46 pregnant women taken into evidence from the first trimester of pregnancy, separated in two groups according to blood glucose determined in the third trimester (before birth): group I normoglycemic and group II with hyperglycemia (>92mg/dl). Results: The mean value of third trimester glycemia for the entire group was of 87.13±22.03. The mean value of the glycemia determined in the third trimester of pregnancy was higher in the second group (109.17 mg/dl) in comparison to the first group (74.,21 mg/dl). The ROC curve for third trimester glycemia as fetal macrosomia appreciation test has an AUC of 0.517. Conclusions: Glycemia determined in the last trimester of pregnancy cannot be used alone as the predictive factor for fetal macrosomia.

scholarly journals Expectant Management Leading to Successful Vaginal Delivery following Intrauterine Fetal Death in a Woman with an Incarcerated Uterus

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Masafumi Yamamoto ◽  
Mio Takami ◽  
Ryosuke Shindo ◽  
Michi Kasai ◽  
Shigeru Aoki
Keyword(s):  
Vaginal Delivery ◽  
Fetal Death ◽  
Expectant Management ◽  
Intrauterine Fetal Death ◽  
Third Trimester ◽  
Spontaneous Reduction

Expectant management leads to successful vaginal delivery following intrauterine fetal death in a woman with an incarcerated uterus. Management of intrauterine fetal death in the second or third trimester of pregnancy in women with an incarcerated uterus is challenging. We report a case of successful vaginal delivery following intrauterine fetal death by expectant management in a woman with an incarcerated uterus. In cases of intrauterine fetal death in women with an incarcerated uterus, vaginal delivery may be possible if the incarceration is successfully reduced. If the reduction is impossible, expectant management can reduce uterine retroversion, thereby leading to spontaneous reduction of the incarcerated uterus. Thereafter, vaginal delivery may be possible.

scholarly journals RARE-04. INTELLECTUAL DEVELOPMENT IN CHILDREN WITH PEDIATRIC CRANIOPHARYNGIOMA AFTER TUMOR REMOVAL

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii442-iii442
Author(s):  
Tatsuki Oyoshi ◽  
Shingo Fujio ◽  
Nayuta Higa ◽  
Hajime Yonezawa ◽  
Koji Yoshimoto
Keyword(s):  
Intellectual Development ◽  
Mean Value ◽  
University Hospital ◽  
Electrolyte Imbalance ◽  
Surgical Removal ◽  
Tumor Removal ◽  
Full Scale Intelligence Quotient ◽  
Verbal Comprehension Index ◽  
The Mean ◽  
Perceptual Reasoning

Abstract INTRODUCTION Intellectual assessment in children with craniopharyngioma after tumor removal is still unknown. We assessed intellectual development in children who underwent microsurgical resection in our institute over the last twelve years. MATERIALS AND METHODS Ten children among 41 patients with craniopharyngioma treated and followed at Kagoshima University Hospital between 2007 and 2019 were reviewed. We also assessed intellectual development in 10 years or younger children with craniopharyngioma one year after tumor removal. Intelligence was assessed using the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-Ⅳ). RESULTS Ten children underwent microsurgical tumor removal. The mean age at surgery was 5.8 (range 1–10) years. Transcranial approach was performed in 8 children, transsphenoidal approach in two children. The mean follow up period was 110 months. Gamma knife surgery (GKS) was performed in 6 children less than 6 months after first surgery. Regional recurrences occurred in 5 children, and additional GKS was performed in four children, second microsurgical removal in one child. Severe obesity with a transient electrolyte imbalance occurred in one child. Eight children with GH deficiency underwent GH replacement therapy. Eight children were assessed working memory index (WMI), processing speed index (PSI), Perceptual reasoning index (PRI), and verbal comprehension index (VCI) using WISC 4. Each mean value of WMI, PSI, and PRI was lower than VCI, except for 2 children with normal full scale intelligence quotient. CONCLUSION WMI, PSI and PRI in children with intellectual disabilities were lower tendency than VCI after surgical removal of craniopharyngiomas in the present study.

Determination Of Malondialdehyde In Normal And Diabetic Pregnancies

1981 ◽  
Author(s):  
I Rákóczi ◽  
Gy Geró ◽  
J Demeter ◽  
I Gáti
Keyword(s):  
Pregnant Women ◽  
Mean Value ◽  
Diabetic Pregnancy ◽  
Diabetic Patients ◽  
Third Trimester ◽  
The Mean ◽  
Platelet Hyperaggregation ◽  
Induced Aggregation ◽  
Increased Activity

It is known that platelet hyperaggregation observed in diabetic patients is, at least in part, due to an increased activity of the endoperoxide-thromboxane forming metabolic pathway. It was interesting to determine the platelet malondialdehyde /MDA/ production in normal and diabetic pregnancies. Following individuals have been studied: /I/ twenty-five healthy non-pregnant volunteers; /II/ thirty women in third trimester of non-complicated pregnancies; /III/ twenty two diabetic pregnant women without retinopathy; /IV/ fifteen diabetic pregnant women with retinopathy. Platelet MDA production following N-ethyl-maleimide induced aggregation was measured according to Stuart et al. The mean value of MDA production was similar in volunteers and normal pregnant women /SDM, 7.07±0.73 nmoles MDA per 109 platelets; 7.22±0.81/. The mean MDA production in diabetic women without retinopathy was slightly but nonsignificantly higher than that in normal pregnant women /7.57±1.02; p>0.05/. The corresponding value in diabetic women with retinopathy was significantly higher than the values in the other three groups /8.47±0.82; p<0.01/. These data suggest that the activation of prostaglandin synthetic pathway /measured by MDA/ is significantly increased in diabetic pregnancy complicated by retinopathy. The increase of platelet prostaglandin synthesis in diabetic pregnancy might play an important role in initiating and/or promoting the small-vessel complications of placenta.

The Contribution of an Infectious Workup in Understanding Stillbirth

2019 ◽  
Author(s):  
Yuval Fouks ◽  
Ariel Many ◽  
Yael Shulman ◽  
Stella Bak ◽  
Shiri Shinar
Keyword(s):  
Medical Records ◽  
Fetal Death ◽  
Acute Infection ◽  
Intrauterine Fetal Death ◽  
Placental Pathology ◽  
Fetal Autopsy ◽  
Fetal Infection ◽  
Included Review ◽  
The Mean ◽  
Infectious Etiology

Abstract Objective This study was aimed to assess the utility of diagnostic tests of maternal and fetal infection in the evaluation of stillbirth. Study Design A single-center retrospective study from January 2011 to December 2016 of all women presenting to the hospital with intrauterine fetal death at or after 20 weeks of gestation. Standard evaluation included review of medical records, clinical and laboratory inflammatory workup, maternal serologies, fetal autopsy, placental pathology, and fetal and placental cultures. A suspected infectious etiology was defined as meeting at least two diagnostic criteria, and only after exclusion of any other identifiable stillbirth cause. Results During the 7-year study period, 228 cases of stillbirth were diagnosed at our center. An infectious etiology was the suspected cause of stillbirth in 35 cases (15.3%). The mean gestational age of infection-related stillbirth was 28 1/7 (range: 22–37) weeks, while for a noninfectious etiology, it was 34 0/7 (range: 25–38) weeks (p = 0.005). Placental histological findings diagnostic of overt chorioamnionitis and funisitis were observed in 31 (88.5%) cases. In 16 (45.7%) cases the placental and fetal cultures were positive for the same pathogen. Serology of acute infection was positive in three (8.5%) of the cases. Conclusion Maternal and fetal infectious workup is valuable in the investigation of stillbirth, particularly before 30 weeks of gestation and should be considered a part of standard evaluation.

scholarly journals Comparison between use of combination of mifepristone and misoprostol versus misoprostol alone in the management of intrauterine fetal death

2018 ◽  
Vol 7 (7) ◽  
pp. 2778
Author(s):  
Sreeveena Talasani ◽  
Pran Hitha Venkamolla ◽  
Kalpana Betha
Keyword(s):  
Side Effects ◽  
Fetal Death ◽  
Intrauterine Fetal Death ◽  
P Value ◽  
Ultrasound Scan ◽  
Efficacy And Safety ◽  
Medical Sciences ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Intrauterine fetal death (IUFD) is estimated to occur in 1% of all pregnancies. The advent of prostaglandins has revolutionized the management of IUFD. There are limited studies using a combined regimen of mifepristone and misoprost for induction of labor in IUFD. Hence this study was undertaken to assess the efficacy and safety of combined regimen with misoprostol alone, in the management of IUFD.Methods: This hospital based prospective study included 60 pregnant women with IUFD admitted at Mediciti Institute of Medical Sciences, during the period January 2015 to July 2016. An ultrasound scan was performed to confirm IUFD and localize the placenta. Women were divided alternatively into 2 groups with 30 in each group (group 1- women received 200 mg mifepristone orally followed by misoprostol after 24 hours & in group 2, 100 µg misoprostol  every 6 hourly for a maximum of 4 doses between gestational age  24-26 weeks, 25-50 µg 4 hourly for a maximum of 6 doses beyond 26 weeks).Results: The mean induction to delivery interval was 10 hours in group 1 and 16.3 hours in group 2 (p value 0.007). Mean dose of misoprostol required in group 1 was 1.87 and 2.67 in group 2 (p value 0.008). With respect to side effects, the two groups did not differ significantly.Conclusions: The combined regimen was more effective than misoprostol for the induction of labour in IUFD, in terms of higher rate of successful delivery and shorter induction to delivery interval. 

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