ABSTRACT
To see the safety and efficacy of cervical Foley catheter insertion in post date pregnancy, for induction of labour, as compared to prostaglandin E[2] vaginal pessary. A comparative, cohort study. The study was conducted in the department of obst / Gynae MH Rawalpindi from Sep 2003 to Sep 2004. There were hundred subjects in each group including both primigravidas and multigravdas upto para 3 with singleton pregnancy, postdates 6-10 days, age 20-30 years, Bishop score 3-6 with adequate pelvis. Sampling technique was convenient, non probability. In primigravidas improvement in Bishop Score after 06 hours was similar in both Group A [Foley catheter] [32%] and Group B [Prostin E[2]] [30%]. While in multigravidas improvement in Bishop Score was more in foley catheter in Group A [36%] as compared to Group B [24%]. The induction delivery interval was 12 hours in 69% cases of Group A and 67% cases of Group B [p< .001]. In Group A 80% patients were delivered by spontaneous vaginal delivery, 9% were delivered by lower segment ceasarian section [LSCS]. Where as in Group B 76% patients were delivered by spontaneous vaginal delivery, 11% were delivered by lower segment ceasarian section [LSCS]. There were 4 cases of non progress of labour, 4 cases of fetal distress, 2 cases of meconium aspiration and 1 case of uterine hyperfunction in Group A. However there were 5 cases of fetal distress, 3 cases of meconium aspiration, 3 cases of uterine hyperfunction and 1 case of uterine rupture in Group B. A good cervical preparation was achieved with Foley catheter by mechanical effect of the distended balloon and by release of endogenous PGE[2] comparable to extra amniotic PGE[2]. The readily available Foley catheter was inexpensive and there were no maternal systemic side effects
Subject(s)
Humans , Female , Adult , Catheterization , Dinoprostone , Pessaries , Treatment OutcomeABSTRACT
Post partum hemorrhage [PPH] is defined as the loss of greater than 500ml of blood from the genital tract in the first 24 hours following delivery. PPH occurs in 2-11% of all deliveries. To compare the efficacy of misoprostol and ergometrine for the prophylaxis of Post Partum Haemorrhage. Prospective study. Gynaecology and Obstetrics Department Military Hospital Rawalpindi. From 01 July 2006 to 31 Dec 2006. A total of 200 patients were recruited in the study, they were divided in two groups, group - I [n- 100] included those patients who were administered ergometrine intravenously at the time of delivery of head for the prophylaxis of post partum haemorrhage, Group - 2 [n-100] included those patients who were administered Misoprostol 800 microgram per rectally just before the start of cesarean section for the same purpose. Blood loss was calculated objectively by squeezing the soaked pads and quantifying the amount of clots in a kidney tray of standard size to be equal to 500ml. In group I [n-100] 15 patients had mild PPH blood loss > 500ml, out of them 03 had severe PPH requiring bimanual message and 02 patients required blood transfusion, in group II[n-100]. 08 patients had PPH, blood loss > 500 ml, out of them 01 patient required uterine message and none required blood transfusion. Chi-square test was applied to compare the efficacy of the two groups, P > 0.05 showed no significant difference in the efficacy of the two groups but the side effects were obviously less in the Misoprostol group. No patient in group II had GI symptoms while 36 patient in group I had retching and, vomiting and 03 patients had raised B.P after the administration of ergometrine. Misoprostol administered per rectally has equal efficacy to ergometrine given intravenously for the prophylaxis of post partum haemorrhage but the side effect profile and patient tolerability is better with Misoprostol