Volume : 7, Issue : 12, December - 2018
COMPARITIVE STUDY OF 50 MCG ORAL VERSUS 25 MCG VAGINAL MISOPROSTAL ADMINISTRATION FOR INDUCTION LABOUR AT TERM
Dr. M. Hindumathi, Dr. B. Tejaswi Prabhanjana, Dr Karthiki
Abstract :
<p> </p> <p class="MsoNormal" style="margin-right:63.0pt;line-height:129%"><b><span style="font-size:12.0pt;line-height:129%;font-family:"Times New Roman Bold","serif"; mso-fareast-font-family:"Times New Roman Bold"">Background and objectives : </span></b><span style="font-size:12.0pt;line-height:129%">Induction of labour is one of the most common</span><b><span style="font-size:12.0pt;line-height:129%;font-family: "Times New Roman Bold","serif";mso-fareast-font-family:"Times New Roman Bold""> </span></b><span style="font-size:12.0pt;line-height:129%">obstetric procedures performed in the world.<span style="mso-spacerun:yes"> </span>Among the various methods of induction of labour, the synthetic prostaglandin E1 analogue ‘Misoprostol’ has emerged as a promising agent for induction of labour. The present study aims to assess and compare the safety and efficacy of 50 </span><span style="font-size:12.0pt;line-height:129%;font-family:"Arial","sans-serif"; mso-fareast-font-family:Arial">µg</span><span style="font-size:12.0pt; line-height:129%"> oral misoprostol and 25 </span><span style="font-size:12.0pt; line-height:129%;font-family:"Arial","sans-serif";mso-fareast-font-family:Arial">µg</span><span style="font-size:12.0pt;line-height:129%"> intravaginal misoprostol for induction of labour at term .</span><b><span style="font-size:12.0pt; line-height:129%;font-family:"Times New Roman Bold","serif";mso-fareast-font-family: "Times New Roman Bold""> <o:p></o:p></span></b></p> <p class="MsoNormal" style="margin-right:63.0pt;line-height:129%"><b><span style="font-size:12.0pt;line-height:129%;font-family:"Times New Roman Bold","serif"; mso-fareast-font-family:"Times New Roman Bold"">Methodology : </span></b><span style="font-size:12.0pt;line-height:129%">This prospective randomized comparative study included 100</span><b><span style="font-size:12.0pt; line-height:129%;font-family:"Times New Roman Bold","serif";mso-fareast-font-family: "Times New Roman Bold""> </span></b><span style="font-size:12.0pt;line-height: 129%">pregnant women at term with obstetric or medical indications for induction of labour. Women either took 50 </span><span style="font-size:12.0pt; line-height:129%;font-family:"Arial","sans-serif";mso-fareast-font-family:Arial">µg</span><span style="font-size:12.0pt;line-height:129%"> misoprostol orally or had 25 </span><span style="font-size:12.0pt;line-height:129%;font-family:"Arial","sans-serif"; mso-fareast-font-family:Arial">µg</span><span style="font-size:12.0pt; line-height:129%"> of misoprostol inserted in the posterior vaginal fornix. In each group, misoprostol administration was repeated every four hours in the same dose until regular uterine contractions were established or to a maximum of six doses. Induction to delivery interval, number of doses of misoprostol required, need for oxytocin augmentation, outcome of labour, maternal and fetal complications for each group were compared.</span><span style="font-size:10.0pt; line-height:129%"><o:p></o:p></span></p> <p class="MsoNormal" style="line-height:.9pt;mso-line-height-rule:exactly"><span style="font-size:12.0pt"><o:p> </o:p></span></p> <p class="MsoNormal" style="margin-right:63.0pt;line-height:135%"><b><span style="font-size:11.5pt;line-height:135%;font-family:"Times New Roman Bold","serif"; mso-fareast-font-family:"Times New Roman Bold"">Results : </span></b><span style="font-size:11.5pt;line-height:135%">The mean number of oral misoprostol doses required for induction was</span><b><span style="font-size:11.5pt; line-height:135%;font-family:"Times New Roman Bold","serif";mso-fareast-font-family: "Times New Roman Bold""> </span></b><span style="font-size:11.5pt;line-height: 135%">significantly shorter(1.78) compared to the mean number of vaginal misoprostol doses(2.9) with P=0.00002 .The mean induction to delivery interval was significantly</span><span style="font-size:12.0pt;line-height:135%">shorter in oral group compared to vaginal group (16.46h in oral group versus<o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size:12.0pt;line-height:115%">21.38h in vaginal group with P=0.003).The percentage of cases requiring oxytocin<o:p></o:p></span></p> <p class="MsoNormal" style="margin-right:82.2pt;line-height:129%"><span style="font-size:12.0pt;line-height:129%">augmentationwas significantly more in vaginal group(76%)than oral group(42%).The improvement in Bishop score after 6 hours was also more in oral group than vaginal group.</span><span style="font-size:10.0pt;line-height:129%"> </span><span style="font-size:12.0pt; line-height:129%">There were no significant differences between the groups with respect to</span><span style="font-size:10.0pt;line-height:129%"> </span><span style="font-size:12.0pt;line-height:129%">mode of delivery, number of failed inductions, maternal complications and fetal outcome</span><span style="font-size:12.0pt;line-height:129%;font-family:"Arial","sans-serif"; mso-fareast-font-family:Arial">.</span><span style="font-size:10.0pt; line-height:129%"><o:p></o:p></span></p> <p class="MsoNormal" style="margin-right:102.2pt;line-height:135%"><b><u><span style="font-size:11.5pt;line-height:135%;font-family:"Times New Roman Bold","serif"; mso-fareast-font-family:"Times New Roman Bold"">Conclusion :</span></u></b><b><span style="font-size:11.5pt;line-height:135%;font-family:"Times New Roman Bold","serif"; mso-fareast-font-family:"Times New Roman Bold""> </span></b><span style="font-size:11.5pt;line-height:135%">Oral misoprostol in dose of 50µg is as efficacious as 25µg vaginal</span><b><span style="font-size:11.5pt; line-height:135%;font-family:"Times New Roman Bold","serif";mso-fareast-font-family: "Times New Roman Bold""> </span></b><span style="font-size:11.5pt;line-height: 135%">misoprostol because of similar labour outcome with shorter induction delivery interval, smaller number of doses required for delivery, lesser requirement of</span><span style="font-size:10.0pt;line-height:135%"> </span><span style="font-size:12.0pt;line-height:135%">oxytocin augmentation with similar maternal and fetal outcome. Oral route of administration is easy and convenient for both patients and caregivers.<o:p></o:p></span></p>
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Download PDF Journal DOI : 10.15373/2249555XCite This Article:
COMPARITIVE STUDY OF 50 MCG ORAL VERSUS 25 MCG VAGINAL MISOPROSTAL ADMINISTRATION FOR INDUCTION LABOUR AT TERM , Dr.M.HINDUMATHI, Dr.B.TEJASWI PRABHANJANA, Dr KARTHIKI , GLOBAL JOURNAL FOR RESEARCH ANALYSIS : Volume-7| Issue-12 | December-2018


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