Induction of Labour (original) (raw)
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A comparative study of misoprostol oral versus vaginal route for induction of labour
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Induction of labour at term is a common obstetric intervention. Prostaglandin E2 has been the agent of choice for pre-induction of cervical ripening for several decades. In recent time, prostaglandin E1 analogue (misoprostol) is a preferred new agent for pre-induction cervical ripening and labour induction owing to inexpensive, stable in room temperature, administrable through several routes. The ideal dose, route, and frequency of administration of misoprostol are still under investigation.Methods: A double blind parallel group placebo control randomized clinical trial was done in the department of obstetrics and gynecology of Agartala Govt. Medical College among 130 pregnant women those required induction of labour. In this clinical trial, the women were allocated by lottery to receive oral misoprostol (25 μg) and vaginal placebo (same dosage) or vaginal misoprostol (25 μg) and oral placebo (same dosage. Both active and placebo drug (25 mcg) were repeated at 4 hours. i...
KYAMC Journal
Background: Induction of labor is its intentional initiation before spontaneous onset, with the aim of vaginal birth which is safe for mother and newborn. The well documented effectiveness of misoprostol in several gynecological and obstetric applications has resulted in enthusiasm for its use. Objective: To see the efficacy and safety vaginal Misoprostal for cervical ripening and labour induction in late pregnancy. Materials and Methods: This single center clinical trial was carried out in the Department of Obstetrics and Gynaecology at Khwaja Yunus Ali Medical College and Hospital in Sirajgonj, Bangladesh from June 2019 to May 2020 for a period of one year. A total of 90 women requiring indicated induction of labour with an unfavourable cervix (Bishop score ≤ 4) were included in the study. They were randomly divided into two groups: 53 women induced with intravaginal misoprostol (Group I) and 37 women induced with transcervical Foley catheter (Group II). Results: Spontaneous vagin...
A comparative study of vaginal misoprostol versus oral misoprostol for induction of labour
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Induction of labour defined as artificial initiation of uterine contractions before the onset of spontaneous labour, after the period of viability, by any methods. The successful outcome depends on the Bishop Score, maternal age and parity. Authors compared the most preferred two routes; vaginal and oral for induction and outcome, adverse events and side effects were noted.Methods: This was a prospective comparative study carried out at SVPIMSR, Ahmedabad, from January 2019 to June 2019, Gujarat, 100 patients who required induction were randomly divided in two groups- Group A received 25µg oral misoprostol, Group B - received 25µg vaginal misoprostol repeated 4 hourly up to maximum five doses in both groups. The induction to delivery interval, mode of delivery, maternal and neonatal outcome and complications were observed.Results: The mean induction to delivery interval was less in vaginal group than oral (18.7 hours in vaginal versus 22.4 hours in oral). Vaginal deliver...
Comparative Study of Efficacy and Safety of Oral Versus Vaginal Misoprostol for Induction or Labour
The Journal of Obstetrics and Gynecology of India, 2013
Objective To compare the efficacy of oral with vaginal misoprostol for induction of labour. Design A randomized trial. Setting Tertiary care hospital. Participants Two hundred women requiring induction of labour. Methods Group A received oral misoprostol 50 mcg 6 hourly maximum 4 doses to 100 patients and Group B received vaginal misoprostol 50 mcg 6 hourly maximum 4 doses to 100 patients. When the patient entered active stage of labour i.e. clinically adequate constractions of 3/10 min of [40 s duration, and cervical dilatation of with 4 cm, further doses of misoprostol were not administered. Statistical analysis was done using chi-square test and t test. Result Both groups were comparable with respect to maternal age, gestational age, indication of induction and initial modified Bishops score Mean number of dosage required for successful induction were significantly less in vaginal group than oral group (in oral groups A were 2.73 ? 0.58, and in vaginal Group B 2.26 ? 0.52, P value \ 0.0001 highly significant). The induction delivery interval was significantly less in vaginal group than oral group (Group A 15.24 ? 3.47 h Group B 12.74 ? 2.60 h, P \ 0.0001 highly significant). Oxytocin augmentation required was less in vaginal group. 26 caesarean sections were performed in oral group and 17 caesarean sections were done in vaginal group (P value 0.06 NS). APGAR score, birth weight, NICU admissions showed no difference between the two groups. Conclusion This study shows that vaginal route of administration of misoprostol is preferable to oral route for induction of labour when used in equivalent dosage of 50 mcg 6 hourly.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017
Background: It was a randomized controlled prospective study. A large number of women in their advanced pregnancies often need labour induction for various reasons. This study aims to evaluate a safe, effective and inexpensive mode of medical induction. The purpose of the study is to evaluate the safety and efficacy of vaginal misoprostol versus oral misoprostol in induction of labour when used in equal doses.Methods: Two hundred patients were included in the study. They were divided into two groups of 100 patients each. One group i.e. Group A received vaginal misoprostol while the other group i.e. Group B received oral misoprostol. The dosage was 50μg every 6th hourly maximum of four doses. The progress of labour in both groups was charted on a partogram. The outcome of pregnancy, maternal and foetal outcomes were statistically analysed.Results: When compared with respect to age, height, gestational age, indication for induction, there was no difference in either of the groups. The...
Comparison of Effectiveness of Induction of Labour between Misoprostol Per Oral and Per Vaginal
Pakistan Journal of Medical and Health Sciences
Introduction: Oral misoprostol as a labor inducing agent (IOL) is quickly attaining popularity under resource constraints due to its cheapness, stability at room temperature, and logistically easier administration in comparison to oxytocin and dinoprostone. We purpose to inspect the effectiveness and safety of a regimen of oral misoprostol in in the Gynae/Obs unit at Rehman Medical Institute, Peshawar Pakistan. Material and Methods: This was Randomized Controlled Trial conducted at department of Gynecology & Obstetrics, Rehman Medical Institute, Hayatabad, Peshawar, from December, 2016 to May, 2017.In this study a total of 200 (100 in each group) patients were observed. After the drug administration, per vaginal examination was done at 4 hourly intervals to see for labor induction/pains. Data was collected by means of proforma. Results: In this study, the mean age was 31.2 with SD ± 3.51 in group B and the mean age was 32.80 with SD ± 4.02 in Group A. Oral route (Misoprostol, 50μg) ...
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.
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.
Postgraduate Medical Journal of Ghana
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 ...
Comparison of Vaginal and Oral Doses of Misoprostol for Induction of Labour in Postdated Pregnancies
Journal of Evolution of Medical and Dental Sciences, 2017
BACKGROUND Considering maternal complications, it is preferred to induce labour after 40 weeks. 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. Aim-The aim of this study was to compare 50 micrograms of oral misoprostol with 25 micrograms of vaginal misoprostol for induction of labour in postdated pregnancies. MATERIALS AND METHODS This is a randomised controlled trial conducted on 68 uncomplicated postdated pregnant women who were admitted to labour ward of King George Hospital, Visakhapatnam, Andhra Pradesh in the months of June, July and August in 2017. Sample size was taken conveniently. 68 pregnant women who were included in the study for induction were divided into either of the two groups and allocation of groups done by simple randomised lot method. In group A, 50 μg of oral misoprostol and in group B 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. The results were interpreted as mean and standard deviation and chi-square test was done to know the statistical significance using SPSS version 15.0. RESULTS In group A, 33 cases were included and in group B 35 cases were included. All women were between 20-25 years of age. The mean number of doses of 50 micrograms oral misoprostol that were required for induction of labour was 1.89 ± 0.769 which was significantly less compared to the mean number of doses required for induction in the vaginal group i.e. 2.94 ± 1.11, with P-value 0.000. 42.4% of cases in Group A and 80.05% of cases in Group B required augmentation with oxytocin. The difference was statistically significant, with P-value 0.001. CONCLUSION In terms of labour induction and maternal outcomes in the postdated pregnant women, oral misoprostol 50 μg is more useful than vaginal misoprostol 25 μg. In mothers receiving oral misoprostol, induction delivery interval and the number of doses were less.