ABSTRACT
OBJECTIVE: To determine the effects of oral misoprostol solution for induction of labour. STUDY DESIGN: This is a prospective observational study. SETTING: This study was conducted in Government Medical College, Aurangabad. METHOD: Patients undergoing induction of labour after 36 weeks of pregnancy were allocated by randomization to induction of labour with oral misoprostol solution administered 2 h apart. Delivery within 24 h after induction with oral misoprostol solution was the primary outcome on which the sample size was based. The data were analysed by Statistical Software for Social Sciences software. RESULT: Two hundred patients were randomly selected for induction with oral misoprostol solution. There were no significant differences in substantive outcomes. Vaginal delivery within 24 h was achieved in 80.5 % of patients. The caesarean section rate was 19.5 %. Uterine hyperactivity occurred in 4 % of patients. The response to induction of labour in women with unfavourable cervices (modified Bishop's score <2) was somewhat slower with misoprostol, induction to delivery interval was more, oxytocin requirement was more, and vaginal delivery rate was less. CONCLUSION: This new approach to oral misoprostol solution administration was successful in achieving vaginal delivery rate in 24 h in 80.5 % of patients; rate of LSCS was less 19.5 %.
ABSTRACT
AIM: The success of induction of labor depends on the cervical status at the time of induction. OBJECTIVE: For effective cervical ripening both Foley's catheter and PGE(2) gel are used. The aim of this study was to compare the efficacy of intra cervical Foley's catheter and intra cervical PGE(2) gel in cervical ripening for the successful induction of labor. STUDY DESIGN: A randomized, prospective study was conducted in the Dept of OBGY, GMCH, Aurangabad from July 2005-January 2008. 400 patients at term with a Bishop's score ≤3 with various indications for induction were randomly allocated to receive (200 pts) intra-cervical Foley's catheter or PGE(2) gel (200 pts). After 6 h post induction, Bishop's score was noted labor was augmented if required. Statistical analysis was done using Chi square test and t test. RESULT: The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed significant change in the Bishop's score, 5.56 ± 1.89 and 5.49 ± 1.82 for Foley's catheter and PGE(2) gel, respectively, P < 0.001; However there was no significant difference between the two groups. There was no significant difference in the side effects. Twenty eight cesarean sections (14%) were performed in Group A and 37 (18.5%) were performed in Group B (not significant). The induction to delivery interval was 15.32 ± 5.24 h in Group A and 14.2 ± 5.14 h in Group B (P = 0.291). Apgar scores, birth weights and NICU admissions showed no difference between the two groups. CONCLUSION: This study shows that both Foley's Catheter and PGE(2) gel are equally effective in pre induction cervical ripening.
