ABSTRACT
Background: Intracervical instillation of prostaglandin E2 is a well-known and widely practiced method of pre-induction cervical ripening. Mifepristone, due to its anti-progesterone action has been found to be a potential cervical ripening agent. This study was conducted to compare the safety, efficacy and outcome of these two drugs in pre-induction cervical ripening.Methods: One hundred antenatal women were recruited for the study; 50 in mifepristone arm and 50 in PG-E2 gel arm. Any singleton term pregnancy in vertex presentation with intact membranes and bishop’s score of <4 was included in the study. Any contraindication for vaginal delivery and any contraindication for mifepristone or PG-E2 were considered as exclusion criteria. Participants in the mifepristone arm were given tablet mifepristone 200 mg orally and those in PG-E2 gel group received endocervical instillation of PGE2 gel 0.5 mg, two doses 6 hours apart (if necessary). Induction of labour was considered successful if the parturient delivered within 48 hours of administration of mifepristone or first dose of PG-E2 gel, with or without labour augmentation with oxytocin. Delivery after 48 hours and caesarean delivery were considered unsuccessful induction.Results: There was a significant improvement in bishop’s score in mifepristone group 5.0±1.55 as compared to PG-E2 gel group 3.64±2.14; p value 0.001.Conclusions: Oral administration of 200 mg mifepristone is a safe, effective and convenient alternative to intracervical instillation of prostaglandin-E2 gel for pre-induction cervical ripening.
ABSTRACT
The ethanol, methanol and acetone extracts of Aloe vera gel were studied for their antimicrobial activity against four Gram-positive and Gram-negative bacteria using agar well diffusion method. The extracts showed varied levels of antimicrobial activity against the tested pathogens. The ethanol and methanol extracts showed higher activity while acetone extract, showed least or no activity against most of the tested pathogens. Fractions obtained from the extracts by Thin Layer and Column Chromatography were studied for their antagonistic properties using Spot Assay Technique. Compounds with maximum antibacterial activity isolated from the ethanol and methanol extracts were identified as p - coumaric acid (Mol. wt.165), ascorbic acid (Mol. wt.177 ), pyrocatechol (Mol. wt.110 ) and cinnamic acid (Mol. wt.148), on the basis of Gas Chromatography Mass Spectrometry. The study suggests the antimicrobial activity of the A. vera gel extract to be dependant on the synergistic effect of different compounds. With the broad spectral antimicrobial effect of A. vera gel, it could be further recommended in the treatment of various bacterial diseases.