Oral Misoprostol Solution for Induction of Labour.

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 %.

Impact of HIGH BMI on Pregnancy: Maternal and Foetal Outcome.

AIM AND OBJECTIVES: To review the effects of obesity (BMI > 30) on antepartum risk/intrapartum risk. To study neonatal outcome of pregnant women with raised BMI. MATERIAL METHOD: BMI of 500 pregnant women booked before 12 weeks calculated and categorised as normal, overweight, obese and morbidly obese at GMCH, Aurangabad. Pregnant women with systemic disease and previous LSCS were excluded. Antepartum, intrapartum and neonatal variables were studied, and statistical analysis was carried out. RESULTS: Antepartum variables: prolonged pregnancy (<0.05), severe PIH (<0.05), PPROM (<0.05), gestational DM (<0.05) and anaemia (<0.05) are strongly associated with raised BMI, whereas abortion (>0.05), oligohydramnios (>0.05), UTI (>0.05) and abruption (>0.05) are not associated with raised BMI. Postpartum variables: PPH (<0.05), pyrexia (<0.05), prolonged hospital stay (<0.05) and lactational dysfunction (<0.05) are strongly associated with raised BMI, whereas UTI (>0.05), thrombophlebitis (>0.05) and endometritis (>0.05) are not associated with raised BMI. BMI Neonatal outcome: IUGR (<0.05), preterm (<0.05), postterm (<0.05), LBW (<0.05) and macrosomia (>0.05) are strongly associated with raised BMI, whereas stillbirth (>0.05), intubation (>0.05), RDS (>0.05) and baby died within 24 (>0.05) are not associated with raised BMI. CONCLUSIONS: Overweight and obesity are risk factors for AP/IP/PP complication.