ABSTRACT
To compare maternal and perinatal outcome in cases of PROM at term, following induction with vaginal misoprostol [P6E1] to shorten the duration of labour with those managed expectantly. Quasi Experimental study. The study was carried out in department of obstetrics and gynecology labour room unit-1, Bahawal Victoria Hospital, Bahawalpur. Term pregnancies [37-42 wks] with PROM and cephalic alive fetuses. Sixty patients with confirmed diagnosis of PROM were randomized into two groups i.e, A and B. Group A comprising 30 patients were induced with tab. Misoprostol 25 ug at 6 hrly interval max of four doses and group B was managed expectantly for 24 hrs followed by induction with intravenous oxytocin. Total duration of labour, mode of delivery, maternal infection rates and, APGAR score at 1 and 5 min. It was found that both groups had similar characteristics, but the misoprostol group had a significantly shortertime interval from PROM to delivery [18.9 vs 27.5 hours] i.e total duration of labour. Caesarean section rates were 20% in the misoprostol group and 30.7% in the other. There were no differences between them regarding fetal well being, complications during labour and delivery and neonatal or postpartum maternal morbidity. Within 24 hours, 44% of women had delivered in the expectant group against 73.3% in the misoprostol group. Immediate labour induction with misoprostol in cases of term PROM shortens the total duration of labour, and the time of maternal hospitalization without any maternal and perinatal outcomes disadvantages
ABSTRACT
To compare the fetal outcome of elective cesarean section with elective vaginal birth for Term Breech presentation in terms of APGAR Score, Respiratory Distress Syndrome, Admission in Neonatology Unit and Neonatal mortality. Quasi experimental study. Department of Obstetrics and Gynaecololgy Bahawal Victoria Hospital, Bahawalpur. Total 120 cases were included in the study divided into two groups, each having 60 fulfilling the inclusion criteria. Group 'A' had those who delivered by planned cesarean and Group 'B' comprised those having planned vaginal delivery. It was found that neonatal mortality was 3.33 in vaginal and 0 in cesarean group. Mean APGAR Score at 1 and 5 minute was 8.47 and 9.53 in vaginal and 8.58 and 9.62 in cesarean group. RDS was more in cesarean [5] than vaginal group [1.6]. Admission in Neonatalogy Unit was more in vaginally delivered group [8.33] as compared to the cesarean section group [5]. Planned cesarean delivery in breech presentation at term is associated with a reduction in neonatal mortality and morbidity as compared to the planned vaginal birth