Labor induction in term premature rupture of membranes: comparison between oxytocin and dinoprostone followed 6 hours later by oxytocin (original) (raw)
Taiwanese Journal of Obstetrics & Gynecology, 2010
Objective: The aim of this study was to compare the efficacy and safety of a prostaglandin E 2 (PGE 2 ) vaginal insert with those of oxytocin for labor induction. The present study also examined whether its use reduces the rate of cesarean delivery in term pregnancies with premature rupture of membranes (PROM) and low Bishop scores. Materials and Methods: A total of 240 women with singleton pregnancies at ≥ 37 weeks, no prior uterine scar, vertex presentations, reactive nonstress tests, PROM for ≥ 12 hours and Bishop scores of ≤ 6 were randomly assigned to receive either oxytocin or vaginal PGE 2 . The primary outcomes were time from induction to delivery and mode of delivery. Results: The time from labor induction to active labor onset was significantly shorter in the oxytocin group than in the PGE 2 group (4.9 ± 4.1 vs. 8.5 ± 3.6 hours; p = 0.02). The time from induction to delivery was also significantly shorter in the oxytocin group (3.4 ± 1.5 vs. 9.6 ± 4.7 hours; p = 0.02). Cesarean delivery rates were statistically similar in the oxytocin and PGE 2 groups (18.3 vs. 20.0%; p = 0.81). Neonatal outcomes were comparable in both groups. Comparable results were observed for nulliparous women included in the study population. Conclusion: Oxytocin treatment seems to be superior to vaginal administration of PGE 2 to induce labor in term pregnancies complicated with PROM and unfavorable services. [Taiwan J Obstet Gynecol 2010;49(1):57-61]
Premature rupture of membranes at term: immediate induction of labor versus expectant management
2014
Objective : To compare the maternal outcomes of immediate induction of labor with expectant management in women presenting with premature rupture of membranes (PROM) at term. Methods : One hundred and fifty two women with PROM at term were randomized into either immediate induction of labor with oxytocin or expectant management for a period of 12 hours. The primary outcome measure was the incidence of clinical endometritis in each group. Secondary outcomes were the mode of delivery, the neonatal outcome and the proportion of women in the expectant management group that progressed to spontaneous labor. Results : The immediate induction arm had a lower caesarean section rate, (7.9% vs 28.9%, P=0.001), higher spontaneous vaginal delivery rate (92.1% vs 71.1%; P=0.001) and lower incidence of clinical endometritis (0% vs 5.3%, P=0.006), when compared with the expectant management arm. The estimated duration of labor was shorter in the expectant management arm (8.9±2.17hours vs 10.6±2.35h...
Duration of Oxytocin and Rupture of the Membranes Before Diagnosing a Failed Induction of Labor
Obstetrics and gynecology, 2016
To compare maternal and neonatal outcomes based on length of the latent phase during induction with rupture of membranes before 6 cm dilation. This is a retrospective cohort study using data from the Consortium of Safe Labor study, including 9,763 nulliparous and 8,379 multiparous women with singleton, term pregnancies undergoing induction at 2 cm dilation or less with rupture of membranes before 6 cm dilation after which the latent phase ended. Outcomes were evaluated according to duration of oxytocin and rupture of membranes. At time points from 6 to 18 hours of oxytocin and rupture of membranes, the rates of nulliparous women remaining in the latent phase declined (35.9-1.4%) and the rates of vaginal delivery for those remaining in the latent phase at these time periods decreased (54.1-29.9%) Nulliparous women remaining in the latent phase for 12 hours compared with women who had exited the latent phase had significantly increased rates of chorioamnionitis (12.1% compared with 4....
Journal of SAFOG, 2016
Objectives To compare the efficacy, side effects and safety of oral misoprostol to intravenous oxytocin infusion for induction of labor in prelabor rupture of membranes (PROM). Materials and methods Two hundred and sixty-six women of prelabor rupture of membranes were assigned to receive either oral misoprostol 100 μg 6 hourly to a maximum 3 doses (misoprostol group, n = 142), or escalating doses of oxytocin infusion up to 20 mIU/min in primigravida and up to 10 mIU/min in multigravida (oxytocin group, n = 114). Results Demographic characteristics were similar in both the groups. The difference in mean induction to delivery interval (8.2 ± 6 hours in misoprostol group vs 12.2 ± 6 hours in oxytocin group) was statistically significant when two groups were compared. The incidence of vaginal delivery (86.1% in misoprostol group vs 84.2% in oxytocin group), and cesarean delivery (13.9% in misoprostol group vs 15.8% in oxytocin group), was almost similar in both the groups. The indicatio...
BMJ Open, 2019
IntroductionPremature rupture of membranes (PROM) occurs at term in 8% of pregnancies. Several studies have demonstrated that the risk of chorioamnionitis and neonatal sepsis increases with duration of PROM. Decreasing the time interval between PROM and delivery is associated with lower rates of maternal infections. In case of an unfavourable cervix, the use of prostaglandin for cervical maturation demonstrates some advantages over oxytocin. The use of double balloon catheter in reduction of PROM duration has not been evaluated in the literature.Methods and analysisWe are conducting a prospective, monocentric, randomised clinical trial on pregnant women with an unfavourable cervix showing PROM at term (RUBAPRO).After 12–24 hours of PROM, women are randomly assigned to one group treated with a double balloon catheter for 12 hours, with oxytocin administered after 6 hours or to the control group treated with 24 hours of vaginal prostaglandin followed by oxytocin infusion alone. Patien...
Prelabour rupture of membranes at term: early induction of labour versus expectant management
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1996
Ol?/ectives: To compare expectant management with early induction of labour in pregnant patients with prelabour rupture of membranes at term and unfavourable cervix. Stud 3, design: A prospective, randomised study of 154 women with prelabour rupture of membranes at term of whom 80 had been managed expectantly, and 74 had undergone oxytocin induction at a rate of 2.5 mU/min. Digital examination was not performed before oxytocin infusion, and the first was delayed until 4 h (nulliparae), or 2 h (multiparae) of regular uterine contractions. Results: The mean period from rupture of membranes to delivery was significantly shorter in the induction group. The mean duration of labour was significantly shorter in the expectant group. Operative vaginal deliveries were more common in the induction group, and fetal distress was the most common cause of operative vaginal deliveries. The caesarean rates were low and similar in both groups. Maternal and neonatal infectious morbidity was similar and no difference was found in the length of hospitalisation. Conclusions: Expectant management in patients with ruptured membranes at term is safe and reduces the frequency of operative vaginal deliveries.
Oxytocin and oral misoprostol for labor induction in prelabor rupture of membranes
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Prelabor rupture of membrane is one of the most common complications of pregnancy, and the best management option for women with this condition is debatable. This study aims to compare intravenous oxytocin with that of oral misoprostol for labor induction in women with prelabor rupture of membrane. Methods: One hundred and forty women at Central Referral Hospital, Gangtok, India were randomized to receive either misoprostol 50 µg orally every 4 hours or intravenous oxytocin. The primary outcome measure was time from induction to vaginal delivery. Results: The mean time±standard deviation to vaginal birth with oral misoprostol was 5.0±2.58 hours compared with 4.33±2.3 h with oxytocin which was just statistically significant (P = 0.048). There were no difference in the maternal secondary outcome, including cesarean birth (ten and twelve respectively) and gastrointestinal side effects. Neonatal outcomes including Apgar scores and admission to ICU (NICU) were not different. Conclusions: Although oxytocin resulted in shorter induction to delivery interval, oral misoprostol is still an effective option for PROM, as delivery and neonatal outcomes were similar.
International Journal of Basic and Clinical Pharmacology, 2016
Premature rupture of membranes (PROM) is defined as rupture of membranes before onset of labor and complicates 5-10 % of pregnancies. At least 80% of cases of PROM occur at term. In spite of many studies available in the literature, the clinical management is surprisingly controversial. 1 Approximately 60-70% of term PROM cases are followed by the onset of labor within 24 h and an additional 20-30% will start within 72 hours. 2,3 Diagnosis and proper management is very important as it is implicated for various fetal and maternal complications generally due to infection. There is a controversy as to whether patients should be kept on conservative management or induction should be carried out. The ACOG guidelines define "the waiting time as an adequate ABSTRACT Background: Premature rupture of membranes (PROM) complicates 5-10 % of pregnancies. Approximately 60-70 % of term PROM cases are followed by the onset of labor within 24 hours. Diagnosis and proper management is very important. In spite of many studies available in the literature, the clinical management is surprisingly controversial. Methods: Study conducted was prospective randomised controlled trial. Total 150 women were selected fulfilling the inclusion criteria, randomly allotted to the 3 groups. In group A, patients were observed for 24 hours. If labor didn't supervene in 24 hours since admission, induction of labor was done depending on the bishop's score. In the group B, labour was induced by vaginal misoprostol 25 micrograms given 4 hourly for 4 doses and in group C, labor was induced by instillation of 0.5mg PGE2 gel in the posterior fornix. The women were observed for onset and progress of labour. Failure of induction was considered if patient was not in established labour within 24 hours of instillation of first dose of cerviprime/misoprostol. Labour was monitored and managed as per hospital protocol. The analysis verified the following variables: duration of latent phase and active phase of labour, mode of delivery (spontaneous/vaccum/forceps/LSCS), third stage complications (PPH/fever/retained placenta), neonatal outcome. Results: Thirty percent women had onset of spontaneous labor during expectant management in group A. The durations of latent phase and active phase of labour were lower in group B and C than group A (9 and 10.4 versus 15 hours; p<0.001) and (4 and 6 versus10 hours; p<0.001), respectively. Immediate induction in group B and C resulted in significantly lower rate of caesarean section (17% and 19% versus 28.5%, P= 0.049) and operative vaginal delivery (5% and 3% versus 13%, P=0.007). Only a few maternal-neonatal infections occurred and no significant difference was noted (2.7% and 3% versus 3.5%, P= 0.71). Conclusions: Immediate induction with prostaglandin shortens the delivery interval and lowers the caesarean section rate as compared to expectant management; however the neonatal outcome is similar in the three groups.
IOSR Journals , 2019
Labor induction is a clinical intervention that has the potential to confer major benefits to the mother and newborn when continuation of pregnancy poses a risk or danger to the outcome of pregnancy. PROM occurs in approximately 5–10 % of all pregnancies, of which approximately 80 % occur at term (term PROM) 1 . Diagnosis and proper management is very important as it is implicated for various fetal and maternal complications generally due to infection. To avoid such a complication, labor is usually induced, once PROM is confirmed.This study was conducted at the department of Obstretics and Gynecology,RIMS ,RANCHI where 150 patients were studied who presented to labour emergency. Group A ,B,C respectively consisted of 50 patients who were induced with dinoprostone gel, vaginal tablet misoprostol and rest for expectant management . Induction with DINOPROSTONE GELproved to be the best..Expectantmanagement only be followed at TERM PROM in absence of medical or obstreticalcomplications.Delay in induction exposes mother and infants to septic work up and infection.(Wagner et al 1989).Use of prophylactic antibiotics,proper antenatal monitoring,minimal vaginal examination examination under proper aseptic conditions,screening of lower genital infections and its adequate treatement are important to prevent PROM and fetomaternal complication.
Journal of Perinatal Medicine, 2011
Objective: To compare the efficacy and safety of two methods for induction of labor after previous cesarean section. Methods: To compare 247 women with a previous cesarean section who were induced with a dinoprostone vaginal insert and 279 women with a previous cesarean section induced with oxytocin, between 2001 and 2008. We evaluated vaginal delivery rate, maternal morbidity and newborn morbidity and mortality. Results: The overall rate of vaginal delivery was 65.2%. We did not find significant differences between induction with dinoprostone vaginal insert and oxytocin in the rate of cesarean section performed (35.6% vs. 34.1%, Ps0.71). There were nine cases of uterine rupture (rate of 1.7%), of which four occurred with dinoprostone vaginal insert and five when using oxytocin (Ps0.89). We found no significant differences in neonatal outcomes. Conclusions: Both tested methods appear to be equally safe and effective for induction of labor in women with a previous cesarean section.