Foley's catheter plus prostaglandin E[2] compared to prostaglandin E[2] alone for induction of labor

To compare the effectiveness of Foley catheter plus prostaglandin E[2] tablets with prostaglandin E[2] tablets alone in cervical ripening and induction of labor. Patients admitted for induction of labor were randomized into 2 groups. Group A received PGE[2] tablets and intracervical Foley catheter. Group B received PGE[2] tablets only. PG tablets were given to a maximum of 2 doses 6 hours apart. All patients had Bishop Score of <5 and no contraindication to vaginal delivery. After 12 hours, Bishop Score was assessed. Patients with favorable cervix [Bishop >/= 7] had artificial rupture of membranes. Syntocinon was started if there are no adequate uterine contractions. 300 patients participated in the study; 150 in each group. Bishop Score after 12hrs was significantly higher in group A compared to group B [7.48 +/- 1.72 Vs 6.09 +/- 1.85, p<0.01] as well as the mean change after 12 hours [3.20 +/- 1.59 Vs 2.37 +/- 1.42, p<0.01]. 14.4% of patients in group A had a Bishop Score of <7 after 12 hours compared to 25% in group B [p<0.05]. The induction to delivery time was significantly less in group A compared to group B [16.81 +/- 3.29 Vs 18.04 +/- 3.53,p<0.01]. Syntocinon was used in 68% of patients of group A compared to 81% of patients of group B [p<0.05]. 74% of group A patients delivered vaginally compared to 70.6% in group B, the difference was insignificant. There was no statistically significant difference regarding the number of C.S. and the number of instrumental deliveries as well. There was no significant difference regarding the incidence of fetal distress, puerperal pyrexia, or uterine hyperstimulation between the 2 groups. The combination of prostaglandin and Foley catheter resulted in better Bishop Score, shorter induction to delivery time, and fewer failed inductions. However, there was no significant effect on vaginal delivery or C.S. rates

Hormonal profile as a prognostic index for patients with 1[st] trimesteric threatened abortion

Evidence in the literature is unclear to the exact predictive value of biochemical markers in determining the persistence of threatened abortions. Twenty pregnant women in the 1[st] trimesters, with demonstrable fetal heart pulsations that complained of symptoms, and showed signs of threatened abortion, were included in this prospective, controlled, clinical study. This cohort was divided according to whether or not the pregnancy continued into two groups: Group A1 [N=15] that included patients that had an ongoing pregnancy and Group A2 [N=5] that included patients that had an ineirtabl abortion. A control group of twenty randomly chosen healthy women was used as a control group [Group B]. On the day of inclusion, venous blood samples were taken in order to estimate serum CA-125, hCG, progesterone and estradiol levels, Participants were followed up clinically till the gestational age of 14 weeks to distinguish those who had an ongoing pregnancy compared to those who eventually aborted. Of the twenty patients with threatened abortion fifteen aborted and five continued to fourteen weeks gestation. CA-125 levels were higher, and BHCG, progesterone, and E2 levels were lower, in Group A1 when compared to Group A2 and Group B. Maternal serum CA-125, BHCG, progesterone and estrogen may be of value in predicting patients that will gain from expectant management of threatened abortion