ABSTRACT
Background: Induction of labour implies stimulation of uterine contraction before spontaneous onset of labour with or without ruptured membranes. Aim of this study was to compare the efficacy and safety of intracervical Foley’s catheter with oxytocin and vaginal misoprostol for labour induction at term.Methods: A total 100 term pregnant women were chosen with bishop score <6 and divided into two groups: Foley’s catheter with oxytocin (Group A) and vaginal misoprostol (Group B). In Group A, a 16 F Foley’s catheter introduced beyond internal os and traction applied every 4 hourly to check for expulsion with simultaneous oxytocin infusion (2 mU/min up to 32 mU/min). In Group B, 25 mcg misoprostol administered every 4 hourly (maximum 6 doses or 150 mcg). Data analysed using SPSS software 20.0. A p value <0.05 was considered statistically significant.Results: No statistical difference found between demographic variables between two groups. Both primigravida and multigravida had poor pre-induction bishop score in both groups. Foley’s catheter (80%) and misoprostol group (96%) had successful induction and was statistically significant (p<0.05). Foley’s catheter took more time from induction-delivery both in primigravida and post-dated pregnant women. The rate of cesarean in Foley’s catheter group was high (62.5%) including 33% cases with failed induction. Foley’s catheter had less maternal and neonatal complications, less NICU admission as compared to misoprostol (p>0.05).Conclusions: Misoprostol was found better for successful induction, decreases induction-to-delivery interval and increases vaginal delivery as compared to Foley’s catheter but it needs constant supervision in view of hyperstimulation and tachysystole.
ABSTRACT
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.