scholarly journals Efficacy Study of Mifepristone in Pre-induction Cervical Ripening and Induction of Labour

2021 ◽  
Vol 23 (3) ◽  
pp. 259-263
Author(s):  
Sanita Kayastha ◽  
Sunima Mainali ◽  
Ritu Subedi
Keyword(s):  
Neonatal Outcome ◽  
College Teaching ◽  
Test Group ◽  
Patient Characteristics ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Control Group ◽  
P Value ◽  
Bishop Score ◽  
Normal Delivery

This study was carried out to see the safety and efficacy of mifepristine as pre-induction cervical ripening agent along with misoprostol in induction of labour. It was a study done from January to June 2020 in Department of Obstetrics and Gynecology, Nepal Medical College Teaching Hospital. Total 120 patients were included in this study. Out of which, 60 women were be kept in test group who were induced by mifepristone and misoprostol and 60 women were kept in control group induced by misoprostol only. Patient characteristics, improvement of bishop score, maternal and neonatal outcome was recorded. Chi- square and T- Test were used to compare the result. Patient characteristics and the Bishop score at zero-hour of both the groups were similar. The mean bishop score 48 hours after use of mifepristine in test group was significantly increased in test group vs control group (P<0.0001). There were total 12(20%) patient who went in to labour with mifepristone only without the use of misoprostol. Total number of normal delivery was more (p value=0.003) and cesarean was less (p=0.013) in test group than in control group. The instrumental delivery in both test and control group were same. The adverse effect and neonatal outcome was similar in both the regime. Thus mifepristone as pre-induction cervical ripening agent is a safe and efficient drug

scholarly journals Obstetric Outcome of Teenage Pregnancy

2014 ◽  
Vol 7 (2) ◽  
pp. 29-32
Author(s):  
S Kayastha ◽  
A Pradhan
Keyword(s):  
Pregnant Woman ◽  
Birth Weight ◽  
Teenage Pregnancy ◽  
Mode Of Delivery ◽  
College Teaching ◽  
Test Group ◽  
Control Group ◽  
Obstetric Outcome ◽  
Normal Delivery ◽  
And Control

Aims: To assess the prevalence of teenage pregnancies and to compare the obstetric performance of teenage pregnant woman with that of adult pregnant woman. Methods: A prospective study was conducted in Nepal Medical College Teaching Hospital from August, 2010 to February, 2012 (one and half year duration). All the teenage pregnancies were included and outcomes were compared with adult (20-24 years) pregnancies, selected randomly who had delivered during the same period of time. The patient characteristics (age, gravidity, parity, gestation age) and obstetric outcome (medical and obstetrical complications, mode of delivery, complications during delivery, fetal outcome, birth weight) were compared between the two groups. Statistical analysis was preformed using PHSTATZ and Z test for proportion. Results: There were total 2708 deliveries during the study period, out of which teenage pregnancy was 264 (9.7%). There were 69(26.1%0) teenage mothers of age 16 to 17 years and 195(73.9%) of age group 18 to 19 years. As expected, maximum patients in the test group i.e. teenagers were primigravida as compared to control group. (90.1% vs. 68.5%). As for mode of delivery, normal delivery in test and control was 82.9% vs 81.1% (p=0.56) and rate of cesarean delivery was similar 10.2% and 10.7%, (p=0.84) in both the groups. The incidence of instrumental delivery was more in control group although it was not statistically significant( 0.7% vs 2.2%, p=0.16). Preterm delivery was 3.0% in teenage as compared to control which is 2.2%. The percentage of intrauterine fetal death was 0.7% vs 0% in test and control group (p=0.15). Proportion of low birth weight babies in test and control group was 7.2% vs 5.9% (p=0.55). Similarly pregnancy related complications were also compared in teenage and control groups. It was found that postpartum hemorrhage occurred more in teenage pregnancy 1.8% vs 0.7% (p=0.84) but statistically not significant. Incidence of hypertensive disorders was 6.4% and 5.6% (p=0.66) in test and control group. Proportion of babies with intrauterine growth restriction was 3.0% in test and 1.1% (p=0.009) in control, the only parameter that is statistically significant. Fetal congenital anomaly was 0.7% vs 0.4% (p=0.54) Conclusions: Teenage pregnancy can have an equally good outcome if we give good obstetric care and encourage institutional delivery. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11139 Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 29-32

scholarly journals Efficacy and safety of oral mifepristone for cervical priming and induction of labor in term pregnancy

2018 ◽  
Vol 7 (7) ◽  
pp. 2766 ◽  
Author(s):  
Abhilasha Gupta ◽  
Aruna Verma ◽  
Iti Madan ◽  
Monika Kashyap
Keyword(s):  
Controlled Trial ◽  
Group Versus ◽  
Perinatal Outcomes ◽  
Active Phase ◽  
Cervical Ripening ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Bishop Score ◽  
Term Pregnancy

Background: The objectives of the study was to assess the efficacy of mifepristone in priming the cervix/inducing labor over next 96 hrs in term pregnancy.Methods: In this single blind randomized controlled trial 200 women with term pregnancy beyond 39 weeks and Bishop’ score <6 were randomly allocated into two groups. Tab Mifepristone 400 mg orally was given to women in study group (n=100) and no intervention in control group (n=100). On follow up one case was lost in control group. All women were observed for change in the bishop’s score or onset of labor in next 96 hrs. If Bishop’s score was <6, the choice of induction was left on the clinician/patient.Results: Mean induction to delivery interval, duration of active phase and improved Bishop score were 79.35±53.43 hr, 2.47±1.23 hr, 6.68±1.69 for study group versus 148±65.66 hr, 3.09±1.45 hr, 5.8±2.15  for control group (p value is <0.001) respectively.  Seventy one (71%) women in study group and 39 (39.3%) women in control group delivered vaginally within 96 hrs without any need of augmentation. There were 9 (9%) caesareans in study group and 24 (24.2%) caesareans in control group but no instrumental delivery in both groups. There was no statistically difference in perinatal outcomes between two groups.Conclusions: Mifepristone is an effective drug for cervical ripening and initiation of labor when given in term pregnancy beyond 39 weeks with poor Bishop’s score (<6) and appearing to reduce need for other agent for augmentation of labor.

scholarly journals Maternal and fetal outcomes with the use of prostaglandins E2 as a cervical ripening agent for induction of labour

2019 ◽  
Vol 9 (1) ◽  
pp. 44
Author(s):  
Shagun Gupta ◽  
Neha Kuntal ◽  
Virendra Kumar Gupta
Keyword(s):  
Neonatal Morbidity ◽  
Modern Medicine ◽  
Labor Induction ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
P Value ◽  
Bishop Score ◽  
Singleton Pregnancy ◽  
Group 2 ◽  
Group 1

Background: In modern medicine induction of labour is required in patients for a good feto-maternal outcome. PGE2 is a prostaglandin analogue which has been used as a cervical ripening agent to improve bishops score. Objective of this study was to evaluate the efficacy of intravaginal PGE2 gel as a cervical ripening agent in unfavourable cervix for induction of labor and any complications associated with its use.Methods: This study comprised of 90 women who required labor induction. Singleton pregnancy above 37 weeks, live intrauterine fetus, Cephalic presentation, Bishop score of 1-6, reactive FHR pattern were included. Women who required only single induction were categorized as Group 1. Those requiring more than one dose after reassessment of bishops scoring at 6, 12 and 18 hours belonged to Group 2.Results: Group1 had more of younger population below 30 years consisting more primigravidas with > 80% women having gestational age of > 39 weeks. Most common indication for induction of labour in both groups was post-dated pregnancy. 65 patients received one dose of cerviprime gel forming Group 1. In Group 2, 72% received 2 doses and 28%, 3 doses of gel. Initial bishops score mean was 4.2 in Group 1 and 4.1 in Group 2. Mean change in bishop score was analysed after 6, 12, and 18 hours of instillations of PGE2 gel. Significant p value was obtained in all groups requiring one, two and three doses of gel. In Group 1, 12.3% and in Group 2, 16% had LSCS. Maternal side effects were minimal and neonatal outcome was good.Conclusions: The study showed that intravaginal application of PGE2 is effective, safe and acceptable method as a cervical ripening agent for labor induction in women with poor bishops score. It reduces caesarean delivery rate without increasing maternal and neonatal morbidity.

scholarly journals A comparative study on the role of oral mifepristone and endocervical prostaglandin as preinduction cervical ripening agent

2020 ◽  
Vol 10 (1) ◽  
pp. 215
Author(s):  
Sanghamitra Mohapatra ◽  
Samarpita .
Keyword(s):  
Single Dose ◽  
Comparative Study ◽  
Substantial Reduction ◽  
Fetal Distress ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Control Group ◽  
Bishop Score ◽  
Medical College ◽  
Dose Oral

Background: Induction of labour is one of the most common interventions practised in modern obstetrics with up to 20% of pregnant women having labour induced in some countries. Induction rates have been influenced by several reports worldwide, which claimed that an active induction policy, led to substantial reduction in perinatal and maternal morbidity and mortality. A ripe or favourable cervix is a pre-requisite for successful vaginal birth. This study is conducted with an aim to compare the efficacy of mifepristone and dinoprostone as a cervical ripening and priming agent for induction of labour and their safety and fetomaternal outcome.Methods: It was a prospective comparative study in the Department of Obstetrics and Gynecology, M.K.C.G. Medical college, Berhampur from October 2017 to October 2019. 100 cases with bishop score less than 6 were subjected for pre induction ripening. These cases were assigned at random either  to study group, who were given single dose oral mifepristone 200 mg and control group with  single dose intracervical E2 gel. All the cases were examined to check the bishop score. In cases of control cases, second dose was given after 6 hours, if there was no improvement in bishop score. At the end of 24 hour if bishop score <6, it was called as failed induction.Results: 90% of mifepristone gr and 56% of dinoprostone gr had improved Bishop score>6 after 6hr.32 cases required oxytocin augmentation in mifepristone gr where as it was 57 in dinoprostone. Drug administration to delivery interval was 19.40 hour in mifepristone gr and 15 hour in dinoprostone gr. More vaginal delivery and less fetal distress in mifepristone gr.Conclusions: Mifepristone is an effective agent for cervical ripening with better fetomaternal outcome compaired to dinoprostone.

scholarly journals Assessment of the Tissue Response to Modification of the Surface of Dental Implants with Carboxyethylphosphonic Acid and Basic Fibroblastic Growth Factor Immobilization (Fgf-2): An Experimental Study on Minipigs

Biology ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 358
Author(s):  
Javier Aragoneses ◽  
Ana Suárez ◽  
Nansi López-Valverde ◽  
Francisco Martínez-Martínez ◽  
Juan Manuel Aragoneses
Keyword(s):  
Surface Treatment ◽  
Test Group ◽  
Mean Value ◽  
Control Group ◽  
P Value ◽  
Implant Surface ◽  
Bone Contact ◽  
Bone Implant ◽  
Significant Difference ◽  
The Mean

The aim of this study was to evaluate the effect of implant surface treatment with carboxyethylphosphonic acid and fibroblast growth factor 2 on the bone–implant interface during the osseointegration period in vivo using an animal model. The present research was carried out in six minipigs, in whose left tibia implants were inserted as follows: eight implants with a standard surface treatment, for the control group, and eight implants with a surface treatment of carboxyethylphosphonic acid and immobilization of FGF-2, for the test group. At 4 weeks after the insertion of the implants, the animals were sacrificed for the histomorphometric analysis of the samples. The means of the results for the implant–bone contact variable (BIC) were 46.39 ± 17.49% for the test group and 34.00 ± 9.92% for the control group; the difference was not statistically significant. For the corrected implant–bone contact variable (BICc), the mean value of the test group was 60.48 ± 18.11%, and that for the control group, 43.08 ± 10.77%; the difference was statistically significant (p-value = 0.035). The new bone formation (BV/TV) showed average results of 27.28 ± 3.88% for the test group and 26.63 ± 7.90% for the control group, meaning that the differences were not statistically significant (p-value = 0.839). Regarding the bone density at the interthread level (BAI/TA), the mean value of the test group was 32.27 ± 6.70%, and that of the control group was 32.91 ± 7.76%, with a p-value of 0.863, while for the peri-implant density (BAP/TA), the mean value of the test group was 44.96 ± 7.55%, and that for the control group was 44.80 ± 8.68%, without a significant difference between the groups. The current research only found a significant difference for the bone–implant contact at the cortical level; therefore, it could be considered that FGF-2 acts on the mineralization of bone tissue. The application of carboxyethylphosphonic acid on the surface of implants can be considered a promising alternative as a biomimetic coating for the immobilization of FGF-2. Despite no differences in the new bone formation around the implants or in the interthread or peri-implant bone density being detected, the biofunctionalization of the implant surface with FGF-2 accelerates the mineralization of the bone–implant interface at the cortical level, thereby reducing the osseointegration period.

scholarly journals Senam Irama Lagu Gizi Seimbang Meningkatkan Kebugaran Pada Anak Sekolah

2020 ◽  
Vol 5 (1) ◽  
pp. 22-29
Author(s):  
Een Juliasti ◽  
Mury Kuswari ◽  
Idrus Jus’at
Keyword(s):  
Physical Activity ◽  
Elementary School ◽  
Test Group ◽  
Wilcoxon Test ◽  
Control Group ◽  
P Value ◽  
Fitness Level ◽  
Rhythmic Gymnastics ◽  
Post Test ◽  
Experimental Group

Physical activity on students in Jakarta is the lowest if it is compared to various regions in Indonesia. The low physical activity has an impact on the declining of health and fitness so that it affects toward the risk of various non-communicable diseases. The purpose of this research is to know the influence of gymnastics rhythm of Gizi Seimbang’s song to the level of fitness on students in State Elementary School Kebon Jeruk 08 Pagi West Jakarta. The type of research uses design experimental quasi research with design of Pre test - post test group control design. This design involves two groups of subjects, one is given an experimental group and one group is not enforced (control group). The population of this study are children aged 10-12 years old with 60 respondents (30 students of gymnastic group and 30 control group students) with gymnastics 3x/week for 12 times. Data analysis use t-dependent test, wilcoxon test because the data is not normally distributed. The result of the research shows that there is the influence of rhythmic gymnastics of Gizi Seimbang’s song to the significant fitness level (p value = 0.0001). Based on the results of this study, gymnastics rhythm of Gizi Seimbang’s song increases the level of fitness compared with control group on students in State Elementary School Kebon Jeruk 08 Pagi West Jakarta.

scholarly journals Assessment of the Role of the Anti-Mullerian Hormone, Luteinizing Hormone/Follicle Stimulating Hormone Ratio in the Diagnosis of Polycystic Ovary Syndrome in Sudanese Women

2018 ◽  
Vol 6 (7) ◽  
pp. 1244-1247
Author(s):  
Hafza Tola ◽  
Mohammed Abbas ◽  
Elsir Abu Alhassan ◽  
Nassr Eldin Shrif ◽  
Mohammed Rida
Keyword(s):  
Luteinizing Hormone ◽  
Polycystic Ovary Syndrome ◽  
Predictive Value ◽  
Polycystic Ovary ◽  
Test Group ◽  
Control Group ◽  
P Value ◽  
Diagnostic Efficiency ◽  
Ovary Syndrome ◽  
Stimulating Hormone

BACKGROUND: The diagnosis of polycystic ovary syndrome (PCOS) is not an easy procedure, as the signs and symptoms are heterogeneous and of undefined aetiology.AIM: This study is aimed to evaluate serum anti-Mullerian hormone (AMH) level and luteinizing hormone (LH)/folic stimulating hormone (FSH) ratio in women with PCOS in Sudan and to assess the diagnostic efficiency for the diagnosis of PCOS.METHODS: In a case-control study, Serum AMH, LH, FSH was measured in the early follicular phase from Sudanese patients (N = 230) with PCOS and100 controls. The LH/FSH ratio was calculated, and its diagnostic power was evaluated by receiver operating characteristic curves.RESULTS: The means of serum AMH, serum LH level and LH/FSH ratio of the test, were significantly increased in the test group compared to the control group (P-value < 0.000). The AMH sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were found to be 83%, 99%, 99%, and 72% respectively. Serum AMH was considered adequate measures for the diagnosis of PCOS; its level showed an area under the ROC curve of 0.98 (95% confidence, P-value < 0.000). The best compromise between 98% specificity and 90% sensitivity was obtained with a cut-off value of 3.3 ng/mL for PCOS diagnosis. There was no correlation between age, body mass index (BMI) and AMH level in the test group.CONCLUSIONS: The Serum AMH level and LH/FSH ratio were higher in patients than in control. However AMH level has better discriminative power and good diagnostic potency for the diagnosis of the PCOS among Sudanese women.

scholarly journals Case-control study of patient characteristics, knowledge of the COVID-19 disease, risk behaviour and mental state in patients visiting an emergency room with COVID-19 symptoms in the Netherlands

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249847
Author(s):  
J. P. M. van der Valk ◽  
F. W. J. Heijboer ◽  
H. van Middendorp ◽  
A. W. M. Evers ◽  
J. C. C. M. in ‘t Veen
Keyword(s):  
The Netherlands ◽  
Emergency Room ◽  
Mental State ◽  
Disease Risk ◽  
Risk Behaviour ◽  
Patient Characteristics ◽  
Control Group ◽  
P Value ◽  
Hygiene Measures ◽  
Pharmaceutical Interventions

Background Coronavirus disease 2019 is a serious respiratory virus pandemic. Patient characteristics, knowledge of the COVID-19 disease, risk behaviour and mental state will differ between individuals. The primary aim of this study was to investigate these variables in patients visiting an emergency department in the Netherlands during the COVID-19 pandemic and to compare the “COVID-19 suspected” (positive and negative tested group) with the “COVID-19 not suspected” (control group) and to compare in the “COVID-19 suspected” group, the positive and negative tested patients. Methods Consecutive adult patients, visiting the emergency room at the Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands, were asked to fill out questionnaires on the abovementioned items on an iPad. The patients were either “COVID-19 suspected” (positive and negative tested group) or “COVID-19 not suspected” (control group). Results This study included a total of 159 patients, 33 (21%) tested positive, 85 (53%) negative and 41 (26%) were COVID-19 not suspected (control group). All patients in this study were generally aware of transmission risks and virulence and adhered to the non-pharmaceutical interventions. Working as a health care professional was correlated to a higher risk of SARS-Cov-2 infection (p- value 0.04). COVID-19 suspected patients had a significantly higher level of anxiety compared to COVID-19 not suspected patients (p-value < 0.001). The higher the anxiety, the more seriously hygiene measures were followed. The anxiety scores of the patients with (pulmonary) comorbidities were significantly higher than without comorbidities. Conclusion This is one of the first (large) study that investigates and compares patient characteristics, knowledge, behaviour, illness perception, and mental state with respect to COVID-19 of patients visiting the emergency room, subdivided as being suspected of having COVID-19 (positive or negative tested) and a control group not suspected of having COVID-19. All patients in this study were generally aware of transmission risks and virulence and adhered to the non-pharmaceutical interventions. COVID-19 suspected patients and patients with (pulmonary) comorbidities were significantly more anxious. However, there is no mass hysteria regarding COVID-19. The higher the degree of fear, the more carefully hygiene measures were observed. Knowledge about the coping of the population during the COVID-19 pandemic is very important, certainly also in the perspective of a possible second outbreak of COVID-19.

scholarly journals The role of oral mifepristone in pre-induction cervical ripening at term

2019 ◽  
Vol 8 (11) ◽  
pp. 4337
Author(s):  
Uma H. Chourasia ◽  
Mudita Kamlesh Jain ◽  
Juzar I. Fidvi
Keyword(s):  
Placebo Group ◽  
Labor Induction ◽  
Cervical Ripening ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Bishop Score ◽  
The Difference ◽  
Pg E2 ◽  
To Receive

Background: Planned induction of labor is an established part of modern obstetrics and is used as a definite form of treatment where continuation of pregnancy would be detrimental to the health of mother or fetus. The objective of this study was to evaluate the effect of mifepristone in pre-induction cervical ripening and labor induction.Methods: A total of 200 pregnant women at term with Bishop Score 4 or less were selected for this prospective randomized placebo-controlled study. The sample was equally divided into study group to receive 200 mg of mifepristone and control group to receive placebo orally for 2 days. Bishop score was assessed at every 24 hours interval till patient entered in spontaneous labor or 72 hours after 1st dose. Women who did not enter labor spontaneously, labor induction was planned with per vaginal insertion of prostaglandin (PG) E2 analogue, Dinoprostone gel 2.5 mg or PGE1 analogue Tab. Misoprostol 25 µg.Results: Ninety-six subjects in the study group and eighty-one in the control achieved successful ripening of cervix and the difference was statistically significant. Sixty-eight of study group and thirty-nine of placebo group entered in spontaneous active labor within 72 hours. Requirement of oxytocin as adjuvant treatment was significantly lower in the study group. Nineteen women of study group and fifteen of control group delivered within 24 hours, and eighty-one of study group and sixty-two of placebo delivered in 48 hours. The mean induction delivery interval was 35.53±13.67 hours in the study group, whereas it was significantly prolonged in the placebo group 50.49±20.92 hours. Eighty-two subjects of study group and seventy-eight of the control group delivered vaginally, the differences were statistically not significant.Conclusions: Mifepristone was found to be an effective agent for cervical priming prior to labor induction in women at term and significantly reduces the induction delivery interval compared with placebo.

scholarly journals A comparative study between endoscope assisted transtympanic pop-in tympanoplasty and permeatal underlay tympanoplasty

2018 ◽  
Vol 6 (2) ◽  
pp. 65-68 ◽  
Author(s):  
Meera Bista ◽  
Toran KC
Keyword(s):  
Success Rate ◽  
College Teaching ◽  
Control Group ◽  
P Value ◽  
Fisher Exact Test ◽  
Taste Sensation ◽  
Exact Test ◽  
Medical College ◽  
Prospective Longitudinal ◽  
Made In

Background: Otoscopic procedure like tympanoplasty is one of the magic wands that an ear nose throat surgeon possesses to alleviate the suffering of a hearing impaired patient. Endoscopic trans-tympanic pop in technique is an alternative method where tympanic fascial graft is placed medial to tympanic membrane remnant through the perforation without elevation of tympanomeatal flap and angled endoscope is used to assess the ossicular chain.Objective: The study was done to compare the results of endoscope assisted trans-tympanic pop-in tympanoplasty with permeatal underlay tympanoplasty.Methods: The study is a prospective, longitudinal and experimental study conducted in Kathmandu Medical College Teaching Hospital from January 2016 to June 2016. A total of sixty-two patients, thirty-one in study and thirty-one in control group were present. The comparison was made in terms of success rate, decrease in taste sensation and time taken for the procedure. Data analysis was done by SPSS version 20. Categorical data were tested by Fisher Exact test and p-value of <0.005 was considered statistically significant.Result: Among 62 patients, 55 had successful graft uptake (88.7% success rate). Hearing improvement was seen in 51 patients (88.25%). Regarding taste sensation 5 out of 62 had decrease in taste sensation after surgery (8%). Time taken was approximately 30 to 45 minutes (mean =44.1min) in endoscopic transtympanic pop-in type and 60 to 90 minutes (mean =73.8 min) in permeatal underlay type.Conclusion: We can conclude that endoscopic trans-tympanic pop-in tympanoplasty gives similar hearing and graft uptake result but with less time and greater ease as compared to permeatal underlay technique.

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