Evaluation of 8-hour and 12-hour urine collection for detection of proteinuria in hypertensive women, Shariati hospital, 2004-2005

Hypertensive disorders are common during pregnancy. Combination of hypertension and proteinuria markedly increase prenatal morbidity and mortality. The gold standard method for proteinuria assessment is 24-hour urine collection. This survey is designed to determine the correlation between protein content of 8-hour and 24-hour urine collections. This cross-sectional study was conducted on 65 pregnant women with gestatinal age of over-20 weeks who were admitted for assessment of proteinuria in obstetrics section of Shariati hospital, Bandar Abbas. Four urine samples were collected from each patient including random sample, 8, 12 and 24-hour samples. Randoms sample was examined qualitatively while other samples were assessed quantitatively. Data were analyzed by Minitab software. Pearson's correlation coefficient of 8-hour and 12-hour samples with 24-hour was calculated. Sensitivity, specificity, negative and positive predictive values of random, 8-hour and 12-hour samples were also determined. Pearson's correlation coefficients of 8-hour with 24-hour and 12-hour with 24-hour were 0.873 [P<0.01] and 0.89 [P<0.01], respectively. 8-hour sample had a sensitivity of 63%and negative predictive value of 82%. The 12-hour and random samples predicted significant proteinuria with a sensitivity of 82% and 75%, specificity of 88% and 63%, positive predictive values of 85% and 62%, and negative predictive values of 86% and 76%, respectively. All patients with proteinuria in 8-hour and 12-hour samples had significant proteinuria in 24-hour sample. There is a strong correlation between 8-hour and 12-hour with 24-hour urine protein levels. Either the simultaneous positive or negative result for proteinuria in 8-hour, 12-hour and random samples is of great significance in documentation or ruling out of proteinuria in 24-hour sample collection

Randomized comparison of vaginal dinoprostone and high dose oxytocin of labor: safety and efficacy

Unripe cervix is the most important factor in failure of labor induction. This study is conducted to compare the efficacy and side effects of Dinoproston and high dose oxytocin as ripening agents in labor induction. In this double blinded randomized clinical trial, 1290 women with unfavorable cervix who underwent labor induction were randomly assigned to vaginal Dinoproston [9 mg] or intravenous high dose Oxytocin [6miu/min] groups. Initial 12 hours Bishop-Score, labor induction to labor duration, delivery type, 1 and 5 minute APGAR, side effects on mother or neonate, hospitalization duration and hospitalization costs were recorded. Data were analysed using t and Chi-square tests by means of Minitab statistical shoftware. The results showed that vaginal Dinoproston was effective in shortening latent phase of labor [P<0.01]. But, mean Bishop-Score over the initial 12 hours, the interval between labor induction to delivery, and side effects for mother or neonate were not different between the two groups. Based on the results, although hospitalization duration was not different between the groups, hospitalization costs for Dinoproston group was significantly higher [P<0.05] It seems that inspite of shortening the latent phase of labor in vaginal Dinoproston group, it is not more effective than high dose Osytocin as an adjuvant to labor induction in women with unfavorable cervix

Comparative efficacy of misoprostol and oxytocin as labor preinduction agents: a prospective randomized trial

The purpose of this study was to compare the efficacy and safety of misoprostol and oxytocin for induction of labor. In this prospective and randomized controlled trial one hundred twenty women with an unfavorable cervix who underwent labor induction were assigned to receive either intravenous high dose oxytocin [6 mlu/min] or intravaginal misoprostol 50 |ug every 6 hours for two doses. Twelve hours later if labor was not established oxytocin induction was initiated per standardized protocol [3 mlu/min]. Mean Bishop Score change [ +/- SD] over the initial 12 hours interval was significantly greater in the misoprostol group [11.98 +/- 1.55] compared with the oxytocin group [8.83 +/- 2.61]. There were no statistically significant differences in the median duration of labor [449 +/- 261.1 min, 514.5 +/- 288.5 min, respectively; P = 0.22], the mode of delivery or the adverse maternal /neonatal out come among the two groups. Use of misoprostol as a labor preinduction / labor induction agent results in greater Bishop score changes compared with high dose oxytocin and both of them are comparable