ABSTRACT
Coronavirus disease-2019 (COVID-19) caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has caused global health crisis. Initially considered a respiratory tract pathogen, it can cause multiple organ dysfunction. It has also been described to predispose to venous and arterial thromboembolism; however, limited published data is available regarding mesenteric thrombosis COVID-19. We report 6 cases of COVID-19 positive patients with mesenteric/intestinal ischemia. These patients were examined with variables including demographics, laboratory blood tests including coagulation panels, medical and surgical history, comorbidities, and postoperative follow-up period.
ABSTRACT
Background: Induction of labour is defined as the stimulationof uterine contractions using medical or surgical means prior tospontaneous labor in order to achieve vaginal delivery.Dinoprostone gel has been widely used as cervical ripeningand inducing agent. There has been a growing interest in usingmisoprostol, a prostaglandin E1 analogue, as an alternativeagent for inducing labor. Hence; the present study wasconducted for comparing the efficacy and safety of misoprostolwith that of dinoprostone as a cervical ripening and inducingagent.Materials & Methods: A total of 60 eligible women whorequired induction of labour were admitted. After taking a wellinformed consent; detailed history, general examination andobstetric examination was conducted. Patients who fulfilled theabove criteria were divided in two groups either to receivemisoprostol tablet 25µg every 4 hourly intravaginally upto amaximum of 5 doses or dinoprostone gel 0.5mg intracervicallyevery 6 hourly upto a maximum of 3 doses. IntravenousOxytocin was administered as and when required in eithergroup. A Performa was filled for each patient and at the end ofstudy data collected from these Performa’s was tabulated in amaster chart. Statistical analysis was done using SPSSsoftware.Results: Initial Bishops score in the misoprostol anddinoprostone group was 3.85±1.26 and 3.89±0.97respectively. Change in the Bishops score after single dose ofmisoprostol and dinoprostone was 5.48±1.89 and 5.0±2.05respectively. This result was statistically not significant. 66.67%of patients in the dinoprostone group where as 60% of patientsin the misoprostol group required oxytocin. This difference wasnot statistically significant. Only 5 subjects required 3 doses ofdinoprostone whereas 14 subjects needed 2 doses and 11subjects needed only 1 dose of dinoprostone. There were 5cases of failure of induction in the dinoprostone group ascompared to only 3 cases in the misoprostol group. The resultwas not statistically significant.Conclusion: Both dinoprostone and misoprostol are equallysafe and efficacious in cervical ripening and labor induction.
ABSTRACT
Background: Labor induction is one of the most frequentprocedures in obstetrics. Several Meta analyses, systematicreviews and randomised controlled trials have assessed thesafety and efficacy of misoprostol as a cervical ripening andinducing agent and have come out with varied opinions.Hence; the present study was undertaken for assessing theefficacy of misoprostol as an inducing agent.Materials & Methods: A total of 30 women were enrolled inthe present study. Only those subjects were enrolled whorequired induction of labour. Clinical examination of all thepatients was carried out and detailed clinical history wasobtained. This was followed by a thorough obstetricexamination. All the subjects received misoprostol tablet 25µgevery 4 hourly intravaginally upto a maximum of 5 doses.Intravenous Oxytocin was administered as and when required.Cases in which the subject failed to enter the active phase oflabour after 24 hours of starting of induction were regarded asfailure of induction.Results: The most common indication of labour induction waspost-dated pregnancy with 11 subjects (36.66%) in themisoprostol group being of post-dated pregnancy. The nextmost common indication for labor induction was Pregnancyinduced hypertension. Fourteen women in the Misoprostolgroup delivered in less than 12 hours. Thus, the vaginaldelivery rates within 12 hours were 66.67% in the Misoprostolgroup. The mean induction to delivery interval in themisoprostol group was 10.40 hours.Conclusion: Misoprostol is an effective method of induction oflabour and is a well-tolerated drug.