ABSTRACT
The efficacy and safety of misoprostol for cervical ripening and labor induction in patients with oligohydramnios was investigated. 57 pregnancies with oligohydramnios and 58 cases with a normal amniotic fluid volume (controls) were enrolled in this prospective trial. All patients received 50 microg of intravaginal misoprostol every 5 h. Primary outcomes were: cesarean section rate; induction to delivery time; oxytocin augmentation; uterine hyperstimulation; meconium passage; fetal heart rate (FHR) changes; fetal distress requiring delivery, and Apgar scores. There were no differences in the mean time to delivery, cesarean section rate, oxytocin augmentation or Apgar scores. The mean induction to delivery time in oligohydramnios and control groups were, 11 h 43 min and 11 h 18 min, respectively (p > 0.05). FHR changes were observed in 26.3% of oligohydramnios group and 32.7% of control group (p > 0.05). There was no statistically significant difference in the cesarean section rate and the uterine hyperstimulation between the 2 groups. These data suggest that misoprostol can be used as an effective agent for cervical ripening and labor induction in pregnancies with oligohydramnios without increasing the risk for perinatal outcome, compared to those with normal amniotic fluid volumes.
Subject(s)
Cervical Ripening/drug effects , Labor, Induced/methods , Misoprostol/therapeutic use , Oligohydramnios , Oxytocics/therapeutic use , Administration, Intravaginal , Adult , Apgar Score , Cesarean Section/statistics & numerical data , Female , Fetal Distress/epidemiology , Gestational Age , Heart Rate, Fetal , Humans , Misoprostol/adverse effects , Oxytocin/administration & dosage , Pregnancy , Prospective Studies , Risk Factors , Time FactorsABSTRACT
Impetigo herpetiformis is a rare pustular disorder affecting mainly pregnant women. We report a 16-yr-old adolescent primigravida, who presented with impetigo herpetiformis at 27 weeks gestation. She had a pustular erythroderma covering her entire body, except face, scalp, and palmoplantar regions, with severe pruritus and pain. After unsuccessful attempts of treatment with systemic corticosteroids, intravenous fluids, and antibiotics, treatment was switched to cyclosporine, but no therapeutic effect could be achieved. Because of the deteriorating condition of the patient, an early delivery decision was made. Her symptoms resolved after delivery, and at day 20 postpartum her skin lesions were completely resolved.
