scholarly journals Labour Induction Methods: An Overview

2021 ◽  
pp. 119-127
Author(s):  
Sanjivani Wanjari ◽  
Anil Wanjari
Keyword(s):  
Cervical Ripening ◽  
Labour Induction ◽  
Pharmacological Agents ◽  
Mechanical Methods ◽  
Surgical Methods ◽  
The Status ◽  
Oxytocin Infusion ◽  
Posterior Fornix ◽  
Foley’S Catheter ◽  
Pharmacological Method

Overall the rate of induced labours has increased and almost 25% of women undergo labour induction worldwide. Cervical ripening and cervical preparedness is necessary before labour can be induced. The status of the cervix is traditionally assessed with help of Bishop’s score. Labour induction becomes necessary when the cervix is not favourable as noted on the cervical scoring system. Mechanical or surgical methods or a combination of both can be sued for labour induction. These include Foley’s catheter induction, sweeping of membranes, amniotomy etc. Pharmacological agents like oxytocin, prostaglandins PGE1 & PGE2 and newer agents like mifepristone can be used.  Mechanical methods like Foley’s catheter induction are associated with lesser FHR variability and decreased rates of caesarean section as compared with oxytocin infusion or prostaglandins used locally. Oxytocin is the most widely used pharmacological method used for induction of labour. Proper titration of oxytocin can result in contractions that mimic normal labour. Oxytocin is often combined with amniotomy.  Prostaglandins PGE1 & PGE2 are safe and effective options for labour induction. Prostaglandin PGE1 or misoprostol is used in the dose of 25 microgram mcg given orally or vaginally or via the sub-lingual route. Prostaglandin PGE2 or dinoprostone is used intra-cervically or vaginally in the posterior fornix. The newer drug mifepristone is being studied as cervical ripening agents because of its anti-progesterone effect.

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.

scholarly journals Use of Misoprostol in Pregnancy- A Review Article

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

scholarly journals Intravaginal Administration Of Misoprostol Alone Versus Misoprostol And Isosorbidemononitrate For Cervical Ripening And Labour Induction

2017 ◽  
Vol 2 (1) ◽  
pp. 37
Author(s):  
Nasreen Noor ◽  
Ambhika Sharma ◽  
Shazia Parveen ◽  
Syed Manazir Ali
Keyword(s):  
Neonatal Outcome ◽  
Active Phase ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Isosorbide Mononitrate ◽  
Group I ◽  
Uterine Hyperstimulation ◽  
Posterior Fornix ◽  
Intravaginal Administration ◽  
Phase Interval

ABSTRACTOBJECTIVES: To compare the efficacy and safety of intravaginal administration of misoprostol  alone versus misoprostol and  isosorbide mononitrate for cervical ripening and labour induction.MATERIAL AND METHODS: One hundred women with term gestation,  Bishop  score <4 with various indications for labour induction were randomly divided into two groups. In Group I, 50 µg of misoprostol tablet was placed intravaginally, 4 hourly maximum upto 4 doses. In Group II,50 µg of misoprostol tablet with 40mg of isosorbide mononitrate was placed intravaginally in posterior fornix upto 4 doses.RESULTS: Two groups were similar in their clinical characteristics. The induction to delivery interval  was 20.8±2.9 hours vs 14.2±2.7 hours in two groups respectively. Misoprostol and isosorbide mononitrate was associated with a shorter induction to delivery interval, decreased oxytocin requirement higher rate of  vaginal delivery i.e 62.8% Vs 53.9% . Uterine hyperstimulation was more common with misoprostol. Neonatal outcome was similar in both the groups.CONCLUSION: The present study suggests that both intravaginal misoprostol and combination of isosorbide mononitrate and misoprostol are safe and effective modes of labour induction. Isosorbide mononitrate and misoprostol is more effective than misoprostol alone in terms of  shorter induction to active phase interval and induction to delivery interval.   

COMPARISON OF SAFETY AND EFFICACY OF INTRACERVICAL DINOPROSTONE GEL AND EXTRA-AMNIOTIC FOLEY'S CATHETER FOR INDUCTION OF LABOUR

2021 ◽  
pp. 13-15
Author(s):  
Radha Garg ◽  
Bharti Saxena ◽  
Neha Dhingra ◽  
Madhu Meena
Keyword(s):  
Mode Of Delivery ◽  
Full Term ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Vaginal Deliveries ◽  
Before And After ◽  
The Difference ◽  
Foley’S Catheter ◽  
Group B

BACKGROUND: The uterus remains quiescent throughout 9 months and begins to act on its own when full term is approached. Almost 50% women deliver in the duration of one week before and after the calculated EDD; and induction of labour is needed in about 20% of women: to increase the success of labour induction, to reduce the duration and complications of labour and to diminish the rate of caesarean sections. Cervical ripening is needed before induction of labour. There are many methods for induction of labour; however till date, none of them can claimed to be the best. To compare the AIM OF PRESENT STUDY: safety and efcacy of Dinoprostone gel versus intracervical foley's catheter for ripening of cervix and induction of labour. Compara MATERIAL AND METHODS: tive prospective study was conducted on 400 full term uncomplicated primigravida women needing induction of labour between January 2019 to June 2020 in department of obstetrics & gynecology at GMC Kota in Rajasthan.Group A: 200 women induced with Dinoprostone gel and Group B: 200 women induced with extra-amniotic Foley's catheter. Baseline characteristics like maternal age, gestational age, indication for induction were comparable in both the groups. The mean induction to delivery interval was shorter in RESULT: group A (12.69 ± 3.64 hours) as compared to Group B (18.17 ± 3.17 hours) and this difference was statistically highly signicant (P = 0.0001). There was no signicant difference observed in mode of delivery, labour progress at 18 hours, indication for caesarean section, maternal side effects, mean birth weight, Apgar score at 5 mins, number of NICU admissions between the two groups. The number of vaginal deliveries we CONCLUSION: re similar in both the groups but mean induction to delivery interval was signicantly shorter with Dinoprostone gel. However, the maternal and fetal outcomes were better in Foley's catheter group although the difference was not statistically signicant

scholarly journals Intra-cervical foley’s catheter or PGE2 gel for induction of labour: which one is better: a prospective study

2021 ◽  
Author(s):  
Khushpreet Kaur ◽  
Balwinder Kaur ◽  
Navneet Kaur ◽  
Gagandeep Kaur
Keyword(s):  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Controlled Study ◽  
Group A ◽  
The Mean ◽  
Foley’S Catheter ◽  
Group B

Background: Labour is clinically defined as the initiation and perpetuation of uterine contraction with goal of producing progressive cervical effacement and dilatation. The Foley’s catheter is an effective alternative to prostaglandins for cervical ripening/labour induction. Study was done to compare the efficacy of intracervical Foley’s catheter and PGE2 gel as a cervical ripening agent and to study maternal and fetal outcome in terms of mode of delivery and Apgar score.Methods: This randomized controlled study was conducted in Obstetrics and Gynaecology department, Government Medical College, Patiala. 200 women with indication for induction of labour were enrolled in the study to investigate the efficacy and fetomaternal outcome of induction of labour with intracervical Foley’s catheter comparing with PGE2 gel.Results: The mean age in group A was 24.41±3.37 and in group B was 24.24±3.17 years. The 95% women were induced successfully in group A and 97% were successfully induced in group B. Preeclampsia and postdatism were the most common indications for induction in both groups. The mean induction delivery interval in group A was 15.20±4.53 hours and in group B was 15.86±4.79 hours. 4.21% cases required NICU admission in group A while in group B, it was 5.15% cases.Conclusions: Our study concludes that there is no difference in efficacy between intracervical Foley’s catheter and intracervical PGE2 gel for induction of labour and both methods are complementary to each other.

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 Sequential Foley Catheter and Misoprostol Versus Misoprostol Alone for Induction of Labor in Postdated Pregnancy: a Randomized Controlled Trial

2020 ◽  
Vol 3 (1) ◽  
pp. 105-112
Author(s):  
Baburam Dixit Thapa ◽  
Tara Manandhar ◽  
Sarita Sitaula ◽  
Tulasa Basnet
Keyword(s):  
Vaginal Delivery ◽  
Controlled Trial ◽  
Foley Catheter ◽  
Induction Of Labor ◽  
Normal Vaginal Delivery ◽  
Pharmacological Agents ◽  
Sequential Group ◽  
Vaginal Misoprostol ◽  
Foley’S Catheter ◽  
Time To Delivery

Introduction: Induction of labor is done with the aim of normal vaginal delivery. There are different methods; mechanical like intra-cervical Foley’s or pharmacological agents like misoprostol ordinoprostone. Objectives: To compare sequential use of Foley’s catheter and vaginal misoprostol in comparison with vaginal misoprostol only. Methods: Patients with period of gestation more than or equal to 41 weeks without any complications were assigned randomly according to computer generated randomization into sequential use ofintracervical Foley followed by vaginal misoprostol after 24 hours (sequential group) or vaginalmisoprostol only. Primary outcome was rate of normal vaginal delivery. Secondary outcomes were induction to delivery interval, maternal and fetal morbidity. Results: Rate of normal vaginal delivery in sequential group (n= 353) and misoprostol alone group(n= 356) was 71.6% and 53.3% (p < 0.001) but the time to delivery from induction is statistically more in sequential group (30.3 vs. 11.2 hours, p< 0.001). Maternal outcomes like postpartum hemorrhage, hyper-stimulation syndrome, chorioamnitis and neonatal outcomes like low Apgar score, meconium stained baby and stillbirth are similar in both the groups. Conclusions: The priming of cervix using intracervical Foley catheter before giving vaginalmisoprostol was beneficial in increasing the rate of normal vaginal delivery but it increased the induction to delivery interval.

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