ABSTRACT
Background: To compare the efficacy of transcervical foley’s catheter with intracervical PGE2 gel for pre -induction cervical ripening.Methods: It was a prospective interventional study conducted between April 2012 to April 2013 in the department of obstetrics and gynecology at L. L. R. M. medical college and S. V. B. P. hospital Meerut. A total of 80 pregnant women of ≥28 weeks of gestation with bishop score less than or equal to 4 and with various indications for induction of labour were randomly allocated to receive intracervical PGE2 gel (Group A) or transcervical foley’s catheter (Group B). Bishop score was repeated after 6 hours by the same person and the results were compared.Results: The groups were comparable with respect to maternal age, gestational age, indications of induction of labour and initial bishop’s score. The intragroup results were calculated by Wilcoxon signed rank test and intergroup results were calculated by Mann Whitney U-test. The change in bishop score in PGE2 group was 3 and in foley’s group was 3.25 after 6 hours of induction (interquartile range of median) which is significant. The mean change in bishops score was 2.65 in PGE2 group and 3.1 in foley’s group after 6 hours of induction and was significant, however the bishop’s score was comparable in both the groups and statistically insignificant.Conclusions: Both foley’s catheter and PGE2 gel are equally effective in pre-induction cervical ripening of cervix.
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.