ABSTRACT
Objectives: To compare the efficacy of amniotomy with spontaneous rupture of membranes in terms of progress of labour, mode of delivery and foetal outcome in primigravidae
Design: Comparative study
Place and Duration: The study was conducted at Gynae Unit-1 Jinnah Postgraduate Medical Center, Karachi over a period of year from 10[th] July 2002 to 9[th] July 2003
Patients and Methods: Two-hundred primigravidae in active labour [at least 4 cm cervical dilatation] were randomly assigned for amniotomy. Subjects were equally divided into two groups. In subjects of Group A amniotomy was carried out and subjects of Group B were left for spontaneous rupture of membranes. Results of both groups were compared for duration of labour, mode of delivery and foetal outcome in terms of Apgar score at 5 minutes and admission to nursery
Results: The mean duration of labour was 6.66 +/- 1.4 hrs in Group-A and 7.66 +/- 1.75 hrs in Group B showing a significant decrease of 1 hour in duration of labour. There was no significant difference in terms of mode of delivery; foetal Apgar at 5 minutes and neonatal admission to nursery in first 24 hrs following delivery also showed non-significant difference between the two groups
Conclusions: Our study showed that artificially rupturing the membranes during active labour in primigravidae significantly decrease the duration of labour while there was no significant difference in terms of mode of delivery and foetal outcome between the two groups
ABSTRACT
To assess the effects of oxytocin [Syntocinon] versus oxytocin plus ergometrin [Syntometrin] in reducing the risk of post partum haemorrhage and to find out their side effects. Comparative analytical study. The study was performed at Jinnah Postgraduate Medical Centre, in the Department of Gynaecology and Obstetrics over a period of one year from January 2002 to December 2002. Three hundred patients were selected by non-probability convenience sampling. This study was conducted on the patients admitted in labour room, with singleton pregnancy in whom vaginal delivery was imminent. The patients were grouped in three categories. The group I comprised of 150 patients who received injection oxytocin 5 unit I/V alone. The group II comprised of 150 patients who received injection oxytocin 5 unit and injection ergometrin 0.5mg. I/M. The injections were given after expulsion of placenta. Blood loss during delivery was estimated by measuring the amount of blood clots and weighing the towels and swabs soaked before and after delivery. Any delayed haemorrhage within in the first 24 hours after delivery was also recorded. Maternal blood pressure was measured immediately after delivery. The side effects like nausea, vomiting and headache were noted from time ranging -l hour after delivery. Data was analyzed using SPSS version 10. The rate of 46.7 percent of blood loss of 500ml in Syntocinon group was observed significantly high as compared to that of 36.7 percent of syntometrin [p 0.05]. The rate of adverse effects in group I was 8 percent and 17.3 percent in group II. The data revealed a significantly high rate [Z=2.39 P=0.008] of adverse effects in group II patients than group I [p 0.05]. Oxytocin alone is as effective as the use of oxytocin plus ergometrin in the prevention of post partum haemorrhage and is associated with significantly fewer maternal side effects