ABSTRACT
Induction of labour after the period of viability by any methods medical, surgical or combined, for the purpose of vaginal delivery. The success of induction, to a great extent, depend upon pre-induction cervical status i.e. cervical ripening. So, ripening of cervix prior to induction i.e. pre-induction cervical ripening is one of the important steps for successful induction of labour. There are different methods for cervical ripening like prostaglandins (PGE). However, use of prostaglandins (PGE) and oxytocin as labour inducing agent has its own adverse effects on maternal and perinatal outcome. So, constant efforts are made for the less use of uterotonins. The present review aims to study the efficacy of oral Mifepristone for improvement in Bishop’s score, requirement of additional uterotonics, induction delivery interval, mode of delivery and neonatal outcome. Electronic databases were searched by using keywords ‘Mifepristone, RU486, PGE2 gel, Cervical ripening, Bishop’s score and Induction of labour’ and eleven articles were found from 2009 to 2018 which fulfils our study criteria and thus they were taken for review. Based on all the studies, Mifepristone appears to be effective cervical ripening in comparison to other agents with significant improvement in Bishop’s score, higher vaginal delivery rate, shorter induction delivery interval and good neonatal outcome.
ABSTRACT
We hereby report the results of a prospective randomized study where we compared efficacy of mifepristone and prostaglandin (PGE2) gel for pre-induction cervical ripening.
ABSTRACT
A genital fistula is an abnormal communication between uterus with either urinary tract or gastrointestinal tract. Although genitourinary fistula is a common entity, rectovaginal or even uterorectal fistula is relatively uncommon. The etiology of fistula is usually due to an obstetric cause in a developing country, whereas, it is gynecological in the developing country. Whether etiology is obstetrical or gynecological, this develops following days of the procedure. Here, we present the case of a 17-year-old girl, who underwent vaginoplasty for cervical atresia and develop uterorectal fistula one and a half year following the first surgery. She was finally managed with hysterectomy
ABSTRACT
Objectives : To compare the duration of labour and maternal outcome in programmed labour protocol and conventional labour protocol followed in our hospital. Materials and Methods : Sixty consecutive uncomplicated primigravida with spontaneous onset of labour, at term in vertex presentation were selected and randomized into study and control groups of 30 each. Study group received programmed labour protocol and the control group received conventional labour protocol. Rate of labour progression, duration of labour, visual analog score, maternal and fetal outcome were studied. Results : 70% of the study group had excellent pain relief. The mean rate of cervical dilatation was 4.2cm/hr in study group and 1.92 cm/hr in control group . The mean duration of 1st, 2nd, 3rd stages were 140.41 mins, 21.24 mins and 6.2 mins respectively in study group as compared to 240.5 mins, 30.63 mins and 7.93 mins respectively in control group. 80 % of the women had vaginal delivery without any major adverse effects. Conclusions : Programmed labour protocol provides effective labour analgesia, augments the process of labour without adverse maternal outcome.