scholarly journals Efficacy of Dinoprostone Vaginal Pessary for Cervical Ripening and Induction of Labour

2021 ◽  
Vol 10 (12) ◽  
pp. 873-877
Author(s):  
Mamatha C ◽  
Sarmishta M ◽  
Dhanalakshmi M.G
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Active Phase ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Time Interval ◽  
Delivery Time ◽  
Phase Time ◽  
Vaginal Pessary

BACKGROUND To evaluate the efficacy of dinoprostone vaginal pessary for cervical ripening and labour induction in term pregnant women. METHODS This was a prospective observational study conducted at Sri Ramachandra Institute of Higher Education and Research from September 2016 to September 2018. The study included pregnant women with singleton pregnancy and gestational age (GA) between 37 weeks and 41 weeks of gestation. The estimated sample size was 100. All 100 women were induced with dinoprostone vaginal pessary. RESULTS The average induction to active phase interval was 10 hours 58 minutes. About 60.3 % of primigravida had an active phase time interval of 12 hours 03 minutes; and 95.2 % of primigravida delivered < 24 hours with a mean induction to delivery time interval of 17 hours 36 minutes. 4 % of primigravida had failed induction. About 84.8 % of multigravida delivered with mean induction to active phase time interval of 08 hours 57 minutes and 100 % of multigravida delivered < 24 hours with a mean induction to delivery time interval of 12 hours 19 minutes. Out of 100 patients, 80 % of patients delivered by spontaneous vaginal delivery with episiotomy, 5 % of patients delivered by assisted vaginal delivery with episiotomy and 15 % of patients delivered by Caesarean section. Almost 97 % of multiparous women delivered vaginally. No adverse maternal and neonatal outcome was noted in the present study. CONCLUSIONS Dinoprostone vaginal pessary is highly effective in the induction of labour at term in properly selected cases. In terms of success and failure, dinoprostone vaginal pessary does not differ much from dinoprostone gel. KEY WORDS Labour Induction, Propess, Dinoprostone

scholarly journals Clinical predictive factors for vaginal delivery following induction of labour among pregnant women in Jordan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rawan A. Obeidat ◽  
Mahmoud Almaaitah ◽  
Abeer Ben-Sadon ◽  
Dina Istaiti ◽  
Hasan Rawashdeh ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Bishop Score ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
The Mean

Abstract Background Induction of labour (IOL) is an important and common clinical procedure in obstetrics. In the current study, we evaluate predictors of vaginal delivery in both nulliparous and multiparous women in north Jordan who were induced with vaginal prostaglandins. Method A prospective study was conducted on 530 pregnant women at King Abdullah University Hospital (KAUH) in north Jordan. All pregnant mothers with singleton live fetuses, who had induction of labour (IOL) between July 2017 and June 2019, were included in the study. Mode of delivery, whether vaginal or caesarean, was the primary outcome. Several maternal and fetal variables were investigated. The safety and benefit of repeated dosage of vaginal prostaglandin E2 (PGE2) tablets, neonatal outcomes and factors that affect duration of labour were also evaluated. Pearson χ2 test was used to investigate the significance of association between categorical variables, while student’s t-test and ANOVA were applied to examine the mean differences between categorical and numerical variables. Linear regression analysis was utilized to study the relation between two continuous variables. A multivariate regression analysis was then performed. Significance level was considered at alpha less than 0.05. Results Nulliparous women (N = 254) had significantly higher cesarean delivery rate (58.7% vs. 17.8%, p < 0.001) and longer duration of labour (16.1 ± 0.74 h vs. 11.0 ± 0.43 h, p < 0.001) than multiparous women (N = 276). In nulliparous women, the rate of vaginal delivery was significantly higher in women with higher Bishop score; the mean Bishop score was 3.47 ± 0.12 in nulliparous women who had vaginal delivery vs. 3.06 ± 0.10 in women who had cesarean delivery (Adjusted odds ratio (AOR) = 1.2, 95% CI: 1.03–1.28, p = 0.03). In multiparous women, the rate of vaginal delivery was significantly higher in women with higher Bishop scores and lower in women with higher body mass index (BMI). The mean Bishop score was 3.97 ± 0.07 in multiparous women who had vaginal delivery vs. 3.56 ± 0.16 in women who had cesarean delivery (AOR = 1.5, 95% CI: 1.1–2.1, p = 0.01). The mean BMI was 30.24 ± 0.28 kg/m2 in multiparous women who had vaginal delivery vs. 32.36 ± 0.73 kg/m2 in women who had cesarean delivery (AOR = 0.89, 95% CI: 0.84–0.96, p = 0.005). 27% of nulliparous women who received more than two PGE2 tablets and 50% of multiparous women who received more than two PGE2 tablets had vaginal delivery with no significant increase in neonatal morbidity. Conclusion Parity and cervical status are the main predictors of successful labour induction. Further studies are required to investigate the benefit of the use of additional doses of vaginal PGE2 above the recommended dose for IOL.

scholarly journals Induction of labour after 37 weeks of pregnancy using foley’s catheter: traction versus non-traction method

2020 ◽  
Vol 10 (1) ◽  
pp. 275
Author(s):  
Jaydeep J. Bhatu ◽  
Disha Patel
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Controlled Trial ◽  
Foley Catheter ◽  
Mode Of Delivery ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Unfavourable Cervix ◽  
Foley’S Catheter ◽  
Traction Group

Background: Cervical Foley’s catheter used now a days for induction of labour alone as well as a combined with cerviprim gel. The objective of the study was to assess the effectiveness of 750 cc traction on Foley catheter with no traction for labour induction in >37 weeks pregnancy.Methods: A randomized controlled trial performed on pregnant women at >37 weeks who were admitted for induction of labour with unfavourable cervix. They were randomly assigned into two groups, Foley’s with 750 cc traction and without traction. The primary outcomes were improvement in Bishop Score, number of favourable cervix following induction and the mode of delivery. The secondary outcomes were neonatal outcome, and maternal infection.Results: A total of 80 pregnant women were randomized into traction group (n=46) and non-traction group (n=34). Traction group had significantly (p=0.0462) higher number of vaginal delivery compared to non-traction group. Participants were comfortable using both methods. There was no difference in neonatal outcomes and risk of maternal infections in both groups.Conclusions: Application of traction did result in more vaginal delivery.

scholarly journals A comparative study of misoprostol oral versus vaginal route for induction of labour

2020 ◽  
Vol 9 (5) ◽  
pp. 1907
Author(s):  
Apratim Mohan DebBarma ◽  
Jahar Lal Baidya ◽  
Debasis Ray
Keyword(s):  
Clinical Trial ◽  
Vaginal Delivery ◽  
Caesarean Section Rate ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Placebo Control ◽  
Vaginal Route ◽  
Double Blind ◽  
Outcome Differences

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. interval till the parturient reached active labour (not exceeding 5 doses). Both primary (induction delivery interval) and secondary outcomes (failed induction, vaginal/caesarean delivery rate, maternal and foetal complications) were statistically analyzed.Results: The mean induction delivery interval (primary outcome) differences were insignificant among both groups (oral versus vaginal). Success rate of induction (56.9% versus 75.4%), mean dosage (misoprostol 90.5 mcg versus 96 mcg) requirement, maternal and foetal complications was indifferent among two groups. The rate of vaginal delivery (within 24 hours of induction) was significantly higher when misoprostol was used through vaginal route. Caesarean section rate trends to be higher when misoprostol was administered orally.Conclusions: Low dose of misoprostol (25 mcg) offer an additional statistically significant clinical advantage in successful vaginal delivery when used vaginally.

scholarly journals The Role of Low Dose Misoprostol in Cervical Ripening and Induction of Labour Beyond the Age of Viability and its Effects on Maternal and Fetal Outcomes

JMS SKIMS ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 18-21
Author(s):  
Humaira Ali ◽  
Cimona Lyn Saldanha ◽  
Tabasum Parveiz ◽  
Rabia Khurshid
Keyword(s):  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
P Value ◽  
Delivery Time ◽  
Fetal Outcomes ◽  
Group I ◽  
Number Of Patients ◽  
Group Ii ◽  
Vaginal Misoprostol

This study was conducted to compare the efficacy and safety of oral (50 μg) and vaginal (25 μg) misoprostol for cervical ripening and induction of labour. Two hundred patients with indications for labour induction randomly received either 50 μg oral misoprostol every 4 h (Group-I) or 25 μg vaginal misoprostol every 4 h (Group-II), for maximum of six doses. Mean induction to delivery time, delivery within 24 hrs, mode of delivery, oxytocin use, number of doses used, failed induction rate and maternal complication and fetal outcomes were compared for the two groups. Mean induction delivery time was significantly longer in Group-I (20.55±5.59 hrs) than in Group-II (16.70±7.12 hrs) (with mean difference of 3.85 and P-value of <0.001). Mean number of doses of misoprostol used for oral and vaginal misoprostol study populations were 2.61±0.94 and2.37±1.20respectively. Oxytocin augmentation was required in significantly more number of patients in oral group (80%) than in vaginal group (68%) with P-value of 0.027. There were 3 failed inductions in the oral and 4 in the vaginal group after a total of six doses of misoprostol. Incidence of maternal and fetal complications was similar between two groups. Our findings indicated that, 25μg vaginal misoprostol has the potential to induce labor as safely as, and more effectively than, 50 μg oral analogue. JMS 2017; 20(1):18-21

scholarly journals Profiling cervical ripening for induction of labour with Foley’s balloon catheter in Ebonyi state, Nigeria: a randomized controlled trial

2021 ◽  
Vol 10 (1) ◽  
pp. 22
Author(s):  
Nnabugwu Alfred Adiele ◽  
Christian C. Mgbafulu ◽  
Arinze Chidiebere Ikeotuonye ◽  
Christian Chidebe Anikwe ◽  
Joshua Adeniyi Adebayo ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Foley Catheter ◽  
Balloon Catheter ◽  
Active Phase ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Controlled Study ◽  
Bishop Score ◽  
Randomized Controlled

Background: The ripeness of the cervix is an important prerequisite to a successful labour induction. Use of extra-amniotic Foley catheter is a mechanical method of cervical ripening with proven efficacy. This study compared the difference in efficacy between 30 ml and 60 ml of water for inflation of Foley catheter balloon when used for cervical ripening during induction of labour.Methods: A single-blind randomized controlled study where 260 term pregnant women with intact membranes and unfavourable cervix were selected for induction of labour and randomized into two equal groups (30 ml- and 60 ml- groups) from October, 2019 to July 2020. Each participant had cervical ripening with the catheter bulb inflated with either 30 ml or 60 ml of sterile water (as assigned to the individual). After achieving favourable cervix (BS ≥6), oxytocin titration was commenced and the labour monitored with the outcomes well documented and statistically analysed.Results: Mean duration to favourable Bishop Score significantly reduced in the 60 ml group (10.8 hours±2.99) as against 12.7 hours±10.0 in 30ml group (p=0.038). Mean duration of active phase of labour was significantly reduced in 60 ml group (5.6 hours±2.4) as against 8.4 hours±3.2 in 30 ml group (p=0.010). Caesarean delivery rate was significantly reduced in the 60 ml groups (p=0.027).Conclusions: The use of 60 ml inflated Foley’s balloon catheter when compared with 30mls to ripen the cervix effectively reduced the duration to favourable Bishop Score, duration of the active phase of labour and the rate of Caesarean sections.  

scholarly journals COMPARATIVE STUDY BETWEEN FOLEY CATHETER AND DINOPROSTONE GEL FOR CERVICAL RIPENING AND INDUCTION OF LABOUR IN PATIENTS AT TERM WITH UNFAVOURABLE CERVIX (BISHOP'S SCORE<4)

2019 ◽  
pp. 1-4
Author(s):  
Shrikant Warade ◽  
Anshul Pahwa ◽  
Savita Dhongade
Keyword(s):  
Foley Catheter ◽  
Mode Of Delivery ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Time Interval ◽  
Vaginal Deliveries ◽  
Unfavourable Cervix ◽  
Group B ◽  
Singleton Pregnancies

BACKGROUND- Since ancient times, labour inducton is a well established obstetric concept. In the past few decades, rate of labour induction has increased dramatically. The primary objective of this study was to compare the efcacy of transcervical foley catheter with intracervical dinoprostone gel for cervical ripening and labour induction in term singleton pregnancies with unfavourable cervix. METHODS- Term singleton pregnancies fullling inclusion criteria were randomized by chit box system to receive intracervical dinoprostone or transcervical foley catheter. Progress of labour was monitored with the help of partogram. Labour augmentation was done by oxytocin. RESULTS- 110 patients in each group were enrolled. Group A was induced with transcervical Foley catheter and group B with dinoprostone gel. Baseline characteristics like maternal age, parity, gestational age were comparable in each group. There was a signicant difference in the Bishop's score (<.0.05) at the end of 12 hours, Group B showing a greater improvement than A. A signicant difference was also observed in the requirement of augmentation with Pitocin, 77.27% in foley group and 63.63% in dinoprostone group . Although, there was no signicant difference observed in the mode of delivery (p>0.05) and induction to delivery time interval (p>0.05) , maternal and neonatal morbidity between the groups. CONCLUSION- To conclude, Dinoprostone is associated with rapid cervical ripening . Although, mean induction to delivery interval and number of vaginal deliveries were comparable between the groups. Moreover, cost and safety prole of foley catheter makes it comparable or even superior to dinoprostone gel for cervical ripening and induction of labour, especially in developing countries.

scholarly journals Effectiveness of dinoprostone vaginal pessary in induction of labour at term

2017 ◽  
Vol 6 (12) ◽  
pp. 5528
Author(s):  
Devdatt L. Pitale
Keyword(s):  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Active Phase ◽  
Induction Of Labor ◽  
Induction Of Labour ◽  
Maternal Anxiety ◽  
Untoward Event ◽  
Vaginal Pessary ◽  
Structural Network ◽  
Unfavorable Cervix

Background: Induction of labour is a very common obstetric procedure worldwide. The ultimate goal of induction of labour is to achieve a successful vaginal delivery. Dinoprostone is a Prostaglandin (PGE2) which acts on the collagen structural network of the cervix and makes it favourable, thus increasing the chances of a successful of a vaginal delivery. This study emphasizes on the importance of having a proper induction protocol in place and at the same time judicious use of the agents for induction of labour. This will help to reduce the maternal anxiety and stress associated with the induction of labour. The present study was undertaken to assess the effectiveness of dinoprostone vaginal pessary in induction of labour at term.Methods: Twenty patients with unfavorable cervix at term were studied for the effectiveness of Dinoprostone vaginal pessary in induction of labor.Results: Among the twenty patients 17 (85%) delivered vaginally within 18 hrs and 3 (15%) were in the active phase of labour. No untoward event was observed in any of the cases with a favorable neonatal outcome in all the cases.Conclusions: Present study shows that Dinoprostone vaginal pessary is a highly effective method of induction of labor at term in properly selected cases. It reduces consistently the number of internal examinations and thus reducing the risk of ascending infections adding to it's safety along with reduced maternal anxiety associated with induction of labour.

scholarly journals Comparative study of induction of labour with dinoprostone gel versus mechanical dilatation in unfavorable cervix (low Bishops Score)

2017 ◽  
Vol 6 (10) ◽  
pp. 4363 ◽  
Author(s):  
Gayatri Mathuriya ◽  
Sharad Pratap Singh Kushwaha ◽  
Shweta Pradhan
Keyword(s):  
Vaginal Delivery ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
P Value ◽  
Common Procedure ◽  
Vaginal Deliveries ◽  
Group A ◽  
The Mean ◽  
Mean Time

Background: Induction of labour is a common procedure in obstetrics, occurring in upto 30% of pregnancies. Objective of present study was to compare the efficacy of double balloon transcervical catheter to that of a PG vaginal insert among women undergoing labour induction in terms of singleton pregnancies of both nulliparous and multiparous women with an unfavorable cervix.Methods: Patient admitted for induction of labour were randomized to receive intravaginal dinoprostone or intracervical Foley’s catheter. Patient not entering active labour and having rupture membranes or arrest of dilatation received IV oxytocin.Results: 150 patients received dinoprostone gel (group A) and 150 patients received Foleys catheter no.18 (group B). The mean time until cervix ripening was less in group A group (0.0001-p value). The mean time until vaginal delivery was less in the Group A group (p value-0.010) among vaginal deliveries more patients in the Group A group delivered within 24 hours (0.0001-P value.). There was significant differences in cesarean delivery rates (8% vs 20.66%, P value-0.0001, sig). Oxytocins is required in both groups (73.33% vs. 78.66%).Conclusions: Group A was associated with more rapid cervical ripening, shorten induction to vaginal delivery interval and greater no. of vaginal deliveries within 24 hours.

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 Induction of labour and its feto-maternal outcome

2019 ◽  
Vol 8 (7) ◽  
pp. 2748
Author(s):  
Mridu Sinha ◽  
Shashi Bala Arya ◽  
Shashi Saxena ◽  
Nitant Sood
Keyword(s):  
Vaginal Delivery ◽  
Statistical Tests ◽  
Post Partum ◽  
Tertiary Care ◽  
Relative Effect ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Time Period ◽  
Increased Risk ◽  
One Year

Background: Induction of labour is an iatrogenic deliberate attempt to terminate the pregnancy in order to achieve vaginal delivery in cases of valid indication. It should be carefully supervised as it is a challenge to the clinician, mother and the fetus. Aim of this study was to find out common indications for IOL in a tertiary care teaching centre and its feto-maternal outcome.Methods: An institutional based retrospective observational study was conducted to describe the prevalence of labour induction and factors associated with its outcome, during the time-period of one year from January 2018 to December 2018, at SRMS IMS, Bareilly. Logistic regression analysis was employed to assess the relative effect of determinants and statistical tests were used to see the associations.Results: Most of the patients were primigravidas of younger age-group. Idiopathic oligohydramnios and postdatism were the commonest indications for induction of labour and Misoprost was the commonest drug used for it. Though majority had vaginal delivery, as the method was changed to combined method it was significantly associated with increased likelihood of LSCS. Similarly there was increased association with maternal cervico-vaginal tear / lacerations as the method was changed to combined type. However there were no association between post-partum hemorrhage, meconium stained liquor or fetal distress.Conclusions: Common indications for induction of labour were oligohydramnios and postdatism. Misoprost can be safely used for induction of labour without any increased risk for LSCS or any fetal / neonatal risks.

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