Labor Induction with Intravaginal Misoprostol versus Spontaneous Labor: Maternal and Neonatal Outcomes.

Purpose: To compare the maternal and neonatal outcomes of pregnant women who had labor induction with intravaginal misoprostol or had spontaneous labor in our clinic. Material-Method. The records of 213 pregnant women, who were followed up in Acibadem Maslak University Hospital for vaginal delivery between June 2021 and December 2021, were retrospectively evaluated. The pregnant women, who gave birth, were divided into 3 groups as follows: spontaneous labor (SL), those induced by a single dose of misoprostol (SDM), and those induced by multiple doses of misoprostol (MDM). The groups were compared in terms of delivery type, the vaginal birth rate within 12 hours, need for intervention, duration of the second stage of labor, cesarean section ratio due to fetal distress, time from the last dose to delivery, and 1st and 5th minute APGAR scores. Results: Among the primiparous pregnant women, 84.7% of SL group, 65.2% of SDM group, and 37% MDM group delivered vaginally within 12 hours (p < 0.05). The time from the last misoprostol dose to delivery was also statistically significantly shorter in pregnant women, who received a single dose of misoprostol (483 vs. 720 min, respectively). When the hospitalization time was evaluated, in the SDM group, the MDM group, and the SL group, it was found to be 611, 831, and 379 min, respectively. In multiparous pregnant women, the hospitalization time was 735 min in the SDM group, 494 min in the MDM group, and 261.5 min in the SL group (p < 0.05). Other than the hospitalization time, when the aforementioned variables were studied in multiparous pregnant women, no statistically significant difference among groups was observed (p > 0.05). Conclusion: Intravaginal misoprostol seems to be a promising medical agent for labor induction due to its high delivery rates within 12 hours and the absence of negative fetal outcomes, its ease of storage, and affordable cost.

Robotic repair of vaginal evisceration after hysterectomy and the role of intraoperative near-infrared fluorescence imaging.

Vaginal evisceration of the small bowel is a rare and potentially life-threatening complication after hysterectomy. This complication requires prompt surgical management and methods of surgical repair include abdominal, vaginal or laparoscopic approaches. We report the first case of robotic approach for repair of vaginal evisceration and intraoperative use of near-infrared fluorescence imaging for the assessment of bowel perfusion in a 63-year-old postmenopausal woman with a history of robotic hysterectomy for cervix cancer. This case demonstrates the safety and feasibility of robotic surgery and the advantage of using intraoperative near-infrared fluorescence imaging for bowel perfusion, a critical factor for surgical decision-making.