ABSTRACT
Background: The mechanism triggering the initiation of human parturition is still an enigma. At term a series of complex physiological, biochemical and physical processes cascade resulting in delivery of the fetus. This study deals exclusively with comparison of normal labour, induction of labour with prostaglandin, and with augmentation by intracervical insertion of PGE2 tablets, amniotomy and smooth muscle relaxant. Advantages and disadvantages of each of the above methods are compared with expectant management of labour. Aim of this study was to compare pros and cons of programmed labour that to with expectant management.Methods: Study was conducted in Department of Obstetrics and Gynaecology, Bharati Hospital and Research Centre, Pune. It was a prospective randomized clinical trial. 100 pregnant full term women, were selected for each group. At 0 hour primiprost tablet is inserted into the vagina close to the cervix. Frequency of repetition of tablet will be at three hours interval. Patient will be monitored.Results: The youngest one being of age 17 years and the eldest being of age 29 years. In this, we observed those primi and 2nd gravida patients 2-2 tablets each in latent phase and 1-1 tablets in active phase. The induction delivery Interval in primigravida was observed to be of average of 9 hours. While in II Gravida was 6.5 hours, in III Gravida 5.5 hours and in IV Gravida 4 hours.Conclusions: It has been proved beyond doubt that by programmed labour, the patient definitely can get the benefit of decrease in duration of labour.
ABSTRACT
Programmed labour is meant to provide pain relief and to hasten the labour process for better obstetric andneonatal outcome. It includes 3 components: active management of labour, use of obstetric analgesia anduse of partography. It was a prospective study for the patients admitted in ASCOMS hospital undergoingprogrammed labour for a period of 2 years from 2017 to 2019. A total of 50 patients underwent programmedlabour in this period. and an equal number of controls were enrolled. The duration of stages of labour,amount of pain relief and maternal and neonatal outcome was noted. In the present study, the duration offirst stage was 3.36 hrs as compared to 5.25 hours in control group which was significantly lower. Theduration of second stage of labour was also significantly lower in study group (27.2 mins vs 56.88 mins).Among the pain relief scores, 8 patients had no pain relief, 9 had mild pain relief, 14 had moderate painrelief while 19 patients had excellent pain relief. The incidence of normal vaginal delivery, LSCS andforceps/ventouse delivery were respectively 88%, 6% and 6% and neonatal outcome was also good.Programmed labour is a safe and effective technique to provide pain free labour to patients and shortenthe duration of labour without inadvertent side effects and excellent maternal and neonatal outcome.
ABSTRACT
Background: Labour is defined as the progressive dilatation of cervix with co-ordinate uterine contractions that effect in and expulsion of the products of conception. Experience has shown that providing pain relief to the mother allays fear, anxiety and provides a more favourable environment for improved obstetric outcome. Aims and Objectives: To compare the effects of programmed labour protocol with epidural analgesia and traditional method of labour. Materials & Methods: This study is a prospective, randomized controlled study conducted in the department of Obstetrics & Gynaecology at Teerthanker Mahaveer Medical College & Research Centre Moradabad. 90 pregnant women in active labour were enrolled in the study. They were allocated to three groups after randomization . Group-A- 30 pregnant women received epidural analgesia. Group-B - 30 pregnant women received programmed labour protocol. Group-C- 30 pregnant women with traditional labour management. Results: There was excellent relief of pain in group A patient compared to other methods with shortening of duration of labour. Conclusion: Labour analgesia is a simple, effective method for painless and safe delivery and thus can reduce the number of caesarean section
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.