Sublingual versus oral misoprostol for induction of labour in prelabour rupture of membranes at term

To compare the efficacy of sublingual with oral misoprostol for induction of labour in primigravida with pre- labour rupture of membranes at term. Randomized controlled trial. Department of Obstetrics and Gynaecology Unit-11, Sir Ganga Ram Hospital, Lahore, from June 2004 to January 2006. The study included 100 primigravidas with singleton pregnancy at term, having pre-labour rupture of membranes and unfavourable Bishop score with no contraindication of induction of labour, vaginal delivery or misoprostol use. The cases were randomized into two equal groups, A and B. Women in the group A were given 100 micro g of misoprostol orally at an interval of 4 hours to a maximum of 2 doses while patients in the group B were prescribed the medicine sublingually [50 micro g, 4 hourly, maximum of 2 doses]. Induction to delivery interval, mode of delivery and fetomaternal complications were main outcome measures of the study. In the sublingual misoprostol group [B], 92% women delivered within 12 hours of induction while 84% of subjects delivered in this time period in oral group [A, p < 0.05]. There was no failed induction in either group. Regarding dosage, 64% of women delivered with single dose in group B while only 32% delivered with single dose in group A [p < 0.05]. The frequency of vaginal delivery was 92% in group B versus 80% in group A, while rate of caesarean section was 8% in the group B and 20% in the group A, which is statistically insignificant. No significant fetomaternal complications were seen in both groups. The efficacy of sublingual misoprostol in the dosage of 50 micro g was comparable to 100 micro g oral dose for the induction of labour in the primigravidas at term with pre-labour rupture of membranes

Fetal biophysical profile; as a tool to predict fetal outcome

To evaluate fetal Biophysical Profile as an effective technique for the assessment of fetal condition and to improve fetal outcome by early detection of fetal hypoxia. Co relational study: The study was carried out for a period of one year from Oct 2004-Oct 2005 at Obstetrics and Gynecology Department of Fatima memorial hospital Lahore. All patients with history of sluggish fetal movements and clinical suspicion of IUGR, were underwent BPP from 32-42weeks. 100 patients were selected and their BPP score was recorded and were followed till delivery. Those who went into spontaneous labor and who were induced monitored during labor and at any sign of fetal distress immediate caesarean section performed. APGAR score of newborn was noted at one and five minutes and those having poor APGAR score were resuscitated and were followed till one week after delivery. APGAR score was compared with BPP score, During this study 100 BPP were performed. 34patients were primigravidas and 66 were multigravidas. Among 100 patients 73hada BPP score of 9-10/10,21 patients had a score of 7-8/10 and 6 patients had 4-6/10. In 2 patients with 4/10 score emergency caesarean section led to the delivery of neonates with APGAR score of 8 at 5 minutes. Majority of patients with normal BPS of 8-9/10 had good APGAR score of 7-8/10.0nly 8 patients having BPP of 9-10/10 had poor APGAR score 6/10 or <6/10. The fetal BPP appears to be an effective technique for assessment of fetal condition