Comparative Study of Misoprostol Versus Dinoprostone for Induction of Labour.

Induction of labour means initiation of uterine contractions (after the period of viability) by any method (medical, surgical or combined) for the purpose of vaginal delivery. It is helpful when the risks of continuation of pregnancy either to the mother or the fetus is more. Some unfavourable conditions like IUGR, PROM, Post –term pregnancy, IUD, Chorioamnionitis, Maternal medical problems like PIH, Diabetes Mellitus, Renal diseases, COPD, Cardiac diseases may call for induction of labour. Various Pharmacological methods have been introduced for both pre-induction cervical ripening and induction of labour are as follows- 1) Prostaglandins 2) Oxytocin 3) Steroid receptor antagonist-Mifepristone 4) Relaxin This study was conducted on nulliparous females in the age group of 20-30yrs, with gestational age more than 34 wks in the Dept. Of Obstetrics and Gynaecology, Index Medical College Hospital and Research Centre Khudel, Indore over a period of 1 year with a sample size of 100 and they were randomized into Group A-receiving 50mcg of misoprost tablet vaginally and Group B -receiving endocervical cerviprime gel. Hence the purpose of this study is to emphasize that misoprostol is a better alternative than dinoprostone for induction of labour at rural hospital setup by comparing their- 1) Success Rate 2) Induction –delivery interval 3) Number of doses required, their cost effectiveness 4) Maternal complications 5) Fetal complications Among these prostaglandins especially prostaglandin E1,because of their short induction delivery interval, easy availability, low price, easy storage at room temperature, low maternal and fetal complication appear to be especially useful.

Outcome of mechanical mode of induction in failed primary labor induction

To determine the role of an alternate [mechanical] inducing agent in failed labor induction. Quasi-experimental study. Labor Ward at Mother and Child Health Center [MCH], Pakistan Institute of Medical Sciences [PIMS] from May 1999 to July 2003. Women with singleton term gestation and normal live fetus undergoing indicated induction of labor were included if Bishop score was < 5 after 12-18 hours of primary induction with PGE2 vaginal tablets. They were then induced with mechanical method i.e. intracervical foley catheter, if fetal status was reassuring and no evidence of labor onset. The main outcome measure was mode of delivery. Secondary outcome measures were induction labor interval and induction delivery interval after second mode of induction and neonatal Apgar score. Thirty-six women received a second mode of induction for failed induction. Four patients were excluded. Of 32 eligible women, 24 [75%] delivered vaginally. Eight patients [25%] had emergency caesarean section. Mean induction labor interval after second mode of induction was 6.8 hours and mean induction delivery interval was 12.39 hours. Mean Apgar score at 1 minute and 5 minutes was similar in both vaginal deliveries and caesarean sections. When an alternate mechanical method was used, 75% of women labeled as "failed induction" delivered vaginally