Outcomes In Elective Induction Of Labour With μg Intravaginal Misoprostol In Postdate Singleton Live Pregnancy At Korle-Bu Teaching Hospital (original) (raw)
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Outcome of Induction of Labour Using 25 Misoprostol in North Central Nigeria: A 5 -Year REVIEW
Background: Induction of labour is a very common procedure in obstetrics that is not without complications if proper patient selection is not followed. Material & Methods: The aim of the study is to determine the incidence of Induction of Labour (IOL), indication and most importantly the outcome of labour when 25ug of misoprostol is used for IOL This was a retrospective study conducted from January 1, 2015 to December 31, 2019 at the University of Abuja Teaching Hospital Gwagwalada. A total of 264 parturient had IOL with misoprostol during the study period. Results: The rate of induction of labour was 2.5%, the most common indication for induction of labour was prolonged pregnancy (43.9%). 50.4% of the parturients gave birth after a dose of 25ug of misoprostol. 81.8% of parturients had successful vaginal delivery while 18.2% had caesarean section due to failed IOL. The commonest maternal complication was perineal laceration. A total of 6 neonates died. Conclusion: Induction of labour with 25ug of misoprostol was associated with a good foeto-maternal outcome however the need for careful patient selection prior to IOL cannot be overemphasized.
Misoprostol for induction of labour: a survey of attitude and practice in southwestern Nigeria
Archives of Gynecology and Obstetrics, 2008
Background Although supported by research evidence, misoprostol for induction of labour remains contentious. Objective To assess perception and practice of obstetricians regarding use of misoprostol for labour induction. Methodology Cross-sectional questionnaire-based survey of Senior Registrars and Consultant Obstetricians in southwestern Nigeria. Results One hundred and six questionnaires were completed (52.8% Consultants; 47.2% Senior Registrars). Most respondents (96, 90.6%) employ misoprostol for induction in both live and dead fetuses with majority having personally prescribed misoprostol for cervical ripening or induction of labour (97.2 and 79.3%, respectively). Fetal tachycardia, hyperstimulation and ruptured uterus were the commonly reported complications. Twenty-six respondents (24.5%) reported being aware of maternal death in relation to misoprostol use. Only 52.9% of the respondents have protocols guiding misoprostol use in their hospitals. More than half of respondents administer misoprostol 50 μg or higher 6 hourly. Most (92, 87.6%) believe that research evidence backs use of misoprostol for the indication; 89.5% of respondents support use of misoprostol. Most respondents (90, 86.5%) disagree with the notion that misoprostol is too dangerous for induction; only 26 respondents (25.1%) considered oxytocin a better choice for induction; 93 respondents (88.6%) agreed that, given cautious use, misoprostol is safe for induction, while 86 respondents (81.9%) considered misoprostol a cost-effective intervention for labour induction in developing countries. Though senior registrars and younger consultants tended to report side effects more frequently than older consultants, they were more likely to support misoprostol for induction of labour than older consultants. This differences were however not statistically significant (P > 0.05). Conclusion Misoprostol is widely utilized by obstetricians for induction of labour in southwestern Nigeria. Fetal and maternal side effects are commonly experienced. We recommend urgent adoption of evidence-based guidelines in every unit using the drug to prevent complications.
2019
Background Vaginal misoprostol has been recommended by the World Health Organization as one of the effective methods for induction of labor. Globally 9.6% of all deliveries follow induction of labor. Although the goal of labor induction is to initiate active labor with subsequent vaginal delivery, some mothers undergoing labor induction delay to get into active labor and some fail completely. The factors associated with delayed onset of active labor following labor induction with vaginal misoprostol have not been sufficiently explored in resource limited settings.Methods We conducted a prospective cohort study over a period of 6 months on the antenatal ward and labor suit of Mbarara Regional Referral Hospital, southwestern Uganda. We enrolled mothers of gestational age at least 28 weeks, with indication for labor induction. They received 50 micrograms of vaginal misoprostol every 6 hours with a maximum of 4 doses and were followed up until onset of active labor. Onset of active labo...
2021
Artificial induction of labor (AIL) is the set of techniques intended to induce childbirth in order to reduce maternal-fetal mortality. The aim of this paper was to study the maternal and fetal prognosis after the artificial induction of labor with misoprostol. It was a descriptive prospective study conducted from September 1, 2018 to February 28, 2019 at the maternity unit of the Referral Health Center (RHC) in commune I of Bamako. It was about any pregnant woman at term who had received misoprostol as part of the artificial induction of labor. 102 cases of artificial induction with misoprostol 200 μg were collected out of 3641 deliveries, or a frequency of 2.8%. The age group 28 - 32 years accounted for 56.86% with an average age of 28.8 years. Multiparous represented 54.90% of the number. The history of diabetes and hypertension involved 37.25% of the pregnant women. The main indication was premature rupture of membranes (PRM) (40.2%). Induction was performed between the 37th and...
Port Harcourt Medical Journal, 2011
Context: Wide spread use of misoprostol is increasingly commoner in our obstetrics and gynaecological practice, most especially for Induction of labour in spite of its serious associated risks of maternal and fetal complications Objective: To determine the use of Misoprostol for induction of labour among the Obstetricians in the West African sub region. Methodology and settings: During the October 2007 pre examination workshop of the West African College of Surgeons (FWACS), Faculty of Obstetrics and Gynaecology 42 examiners responded through structured questionnaires on the use of misoprostol for induction of labour (IOL) in their institutions of practice. Results: About 91 % admit using misoprostol for IOL with only half (50%) having written protocols for labour induction with misoprostol. Almost all (93%) prefer the vaginal route for the administration of misoprostol and about 74% do not use misoprostol for those with Caesarean section scar compared to only 19% who do. Misoprostol is used for cervical ripening and control of post partum haemorrhage among 24.4% and 50% of the Obstetricians respectively. The commonest complications encountered were Fetal distress, uterine rupture and uterine hyper tonus among 54.8%, 52.4% and 45.2% of the respondents. Conclusions: Misoprostol use was high with yet serious complication occurring among those using it for IOL. Despite the manufacturers and other regulatory agents warning against its use in pregnancy because of serious maternal and fetal complications, misoprostol use for IOL is widespread. A regulated use of this drug especially in pregnancy is advocated.
Tropical journal of obstetrics and gynaecology, 2013
Context: Induction of labour is an old procedure performed to artificially terminate pregnancy for various indications in the interest of the mother, the fetus or both. The aim is to achieve vaginal delivery. Various methods have been in use which include the use of Misoprostol, Dinoprostone, oxytocin infusion and others. In an effort to determine which agent gives better outcome studies were carried out comparing the agents with one another. Objectives: To compare the outcomes of labour induced with Misoprostol and Dinoprostone and to determine the incidence of induction of labour at Aminu Kano Teaching Hospital Kano Nigeria. Materials and Methods:The study was restrospective involving a total of 364 patients admitted for labour induction between January 2005 to December 2009. Out of this 274 were induced with Misoprostol and 90 were induced with Dinoprostone. Results: The incidence of labour induction is 2.35%. The indications include postdatism, Hypertensive disorders of pregnancy, PROM, IUFD and others such as Sickle cell disease, and Diabetes Mellitus. The most common indication was postdatism 45.9%. The success rate was 83.9% for Misoprostol and 82.2% for Dinoprostone. There is a statistically significant difference in terms of shorter induction delivery interval in favour of Misoprostol. There were less number of babies with APGAR score less than 6 in the Misoprostol group. There is no statistically significant difference in terms of the spontaneous vaginal deliveries and caesarean section rates between the two groups. Conclusion: The rate of induction of labour in the centre is 2.35%. Misoprostol was found to be a more efficient and safer agent for induction of labour if the procedure is well managed. It was associated with shorter induction delivery interval without compromising the fetomaternal outcome compared to Dinoprostone.
Journal of Medical Science And clinical Research, 2018
Background: Induction of labour is defined as the process of artificial stimulation of uterine contractions before the spontaneous onset of labour. Amongst the plethora of techniques available for induction of labour, Prostaglandins remain the single most effective mean of cervical ripening and inducing labour. Objectives: Current study was carried out to compare the efficacy of sublingual misoprostol with intravaginal misoprostol for induction of labour. Methodology: This was a hospital based randomized prospective study conducted in the Department of Obstetrics and Gynaecology at RIMS Imphal. 462 women at term pregnancy with single live foetus having Bishop Score ≤6 who required induction of labour for various indications were enrolled and randomly allocated into two groups. Group 1 received 50mcg misoprostol vaginally while second group received same dose of misoprostol sublingually every 4-6hourly. Outcome measures related to labour and maternal and fetal side effects were compared. Results: There was no significant difference between both groups with regards to base line characteristic , indications for induction of labour, mean interval from the initiation of induction to the delivery, neonatal outcome and maternal complications. However significant difference was observed in Bishop Score after 4 hours and requirement of oxytocin augmentation. Conclusion: Misoprostol can be used either sublingually or by vaginal route for induction of labour at term without any major fetal and maternal side effects.
"An Assessment of Induction of Labour with Misoprostol Per- vaginaly in Postdated Pregnancies"
Introduction: Induction of labour is the artificial initiation of labour before its spontaneous onset for the purpose of delivery of the foetoplacental unit using mechanical or pharmacologic methods. Considering maternal complications, it is preferred to induce labour after 40 weeks. In Bangladesh very few studies have been conducted on this issue. Aim of the study: The aim of this study was to assess the effectiveness of 25 micrograms of vaginal misoprostol for induction of labour in postdated pregnancies and to reduce the rate of Caesarean section in postdated pregnancies Methods: This was a prospective observational study which was conducted in the Chowgasa Upazilla Health Complex of Jashore district of Bangladesh during the period from May 2019 to December 2019. In total 150 women with uncomplicated postdated pregnancy who were admitted to labour ward of the mentioned health complex were selected as the study population. For each of the participants 25 μg of vaginal misoprostol was used for inducing labour. Gestational age, parity, Induction starting time with misoprostol, initiation of uterine contractions, induction delivery interval, caesarean section and vaginal delivery rate and other variables including tachysystole, improvement in Bishop score, foetal outcome were recorded on the checklist. Result: In this study, we found in the highest 94(62.67%) cases the gestational age was 40-41 weeks and in 56(37.33%) cases gestational age was 41-42 weeks. In analyzing the gravidity of the participants we found 22(14.67%) participants were with primi-gravida whereas 128(85.33%) participants were with multi-gravida. In this study, for the highest 100(66.67%) % cases single induction dosage were required whereas 2 dosage were required for 50(33.33%) participants. In this study the induction had been failed on 31(20.67%) and had been successful on 119(79.33%) cases. On 119(79.33%) cases normal delivery were performed whereas on 31(20.67%) cases LSCS were performed.Although we had the arrangements of Forceps/Vacuum procedure also but that wasn't in needed for any participants in this study. In this study among all the participants in only 2.67% cases (n=4) uterine tachysystole was found as the complication whereas no complication 146(97.33%). In Apgar score analysis of this study population we found the Apgar score at 1 min < 7 in 17(11.33%) cases and ≥7 in 133(88.67%) we also found of this study population we found the Apgar score at min < 7 in 7(4.67%) cases and ≥7 in 143(95.33%). Conclusion: In this study the induction had been failed on 31(20.67%) and had been successful on 119(79.33%) cases. So the success rate of induction of labour with misoprostol per-vaginaly was satisfactory. These findings may be helpful for further studies and in the treatment arena.
2023
Objective: To compare the effectiveness and safety of 50μg of sublingual misoprostol administered six (6) hourly to that of 50μg of vaginal misoprostol administered four (4) hourly. Methodology: A non-blinded, randomized controlled trial conducted from Sept 1, 2014, to Nov 31, 2014, at a tertiary hospital in Ghana. Hundred and sixty women with medical or obstetric indications for labour induction were randomized into two groups. Results: The rate of vaginal delivery, caesarean section, uterine tachysystole and uterine hyperstimulation were similar in both groups. Sixty-three (78.8%) and 66 (82.5%) mothers in the vaginal and sublingual groups delivered vaginally. More (10.0%) mothers in the vagina group required emergency caesarean for foetal distress. Six (vaginal group) and 8 (sublingual group) of the mothers required emergency caesarean for cephalopelvic disproportion. Three mothers from each group had an emergency caesarean section due to failed labour induction. Almost the same number of mothers had uterine tachysystole in both groups. More (3.8%) mothers in the vaginal group had uterine hyperstimulation. Differences in the mean induction delivery interval and the need for oxytocin augmentation were not significant. No differences were found in the intrapartum passage of meconium, blood loss in the third stage of labour, 5-minute Apgar score <7, and neonatal intensive care unit admissions. Conclusion: The sublingual regimen was as effective and safe as the vaginal regimen in achieving vaginal delivery.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Induction of labour is defined as the process of artificially initiating uterine contractions, prior to their spontaneous onset, with progressive effacement and dilatation of the cervix and ultimately, the delivery of the baby. 1 There are many indications for term labour induction, including post dated pregnancy, preeclampsia, diabetes mellitus, oligohydramnios, intrauterine fetal growth retardation and abnormal ante partum fetal surveillance results. 2 With more than 15% of all gravid women requiring aid in cervical ripening and labour induction, there is widespread interest in, and demand for, an effective and safe method of assistance. The immature cervix is the greatest barrier to labour induction. As oxytocin affects mostly uterine contractions and minimally cervical ripening, prostaglandin agents are the first choice for labour inductions as they exert a local effect on the ABSTRACT Background: With more than 15% of all gravid women requiring prostaglandins in cervical ripening and labour induction. However, evidence is not clear about the preferred route or dose of the drug. So this study was designed with objectives to compare the induction delivery interval and safety of titrated oral misoprostol solution with vaginal misoprostol for labour induction in term primigravida women. Methods: In this randomised controlled trial out of 576 eligible women, 220 women as per inclusion criteria between 37 and 42 weeks of gestation with an unfavourable cervix (Bishop score <6) with indication for labour induction were randomly assigned (110each) to receive titrated oral solution of 20 mL misoprostol solution (1 mcg/mL) every 1 hour for four doses and then were titrated against individual uterine response or vaginal misoprostol 25 mcg every 4 hours. Vaginal delivery within 12 hours was the primary outcome. The data were analyzed by intention-to-treat. Results: Vaginal delivery occurred within 12 hours in 56 (50.9%) women in the titrated oral group and 24 (21.8%) women in the vaginal group with significant p-value (<0.001). The incidence of caesarean, hyper stimulation, low apgar score was less in the titrated oral group. More women experienced nausea in the titrated oral group. Conclusions: Titrated oral misoprostol is safe and effective for labour induction in primigravida patients with unfavourable cervix.