Keywords : misoprostol
Manual vacuum aspiration with medical method of abortion in termination of pregnancy up to 9 weeks of gestational age: A comparative study
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 1109-1118
Introduction:Unsafe abortions are a serious public health issue in India, involving the expulsion or extraction of the product of conception and causing controversy.Unmet demand exists for a simple, effective early pregnancy termination method that is both accessible and safe. Medical abortion using mifeprostone and misoprostol and surgical abortion using manual vacuum aspiration are two procedures that meet this need.
Materials and Methods:All requirements outlined in the MTP Act of 1972 by the Government of India were followed in this study. On the first day of the medical abortion, the patient was given 200 mg of mifepristone orally. After 48 hours at home, the patient was told to keep using Tab. Misoprostol 800ug vaginally.A 60ml double-valved manual vacuum aspiration syringe was used for MVA. Following the MVA syringe's attachment, the contents were aspirated. Villi on fresh tissue served as proof that the procedure was successful.The aspirated uterine contents were placed on a piece of gauze and examined to determine the gestational sac. Each woman was under observation for at least four hours following the procedure. The vital signs were examined before discharge. Inj. Women with Rh negative blood groups received 300ug of anti-D within 72 hours of the abortion.
A comparative study of oral V/S vaginal misoprostol for induction of labor conducted at Karwar institute of medical science, Karwar, Karnataka
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 332-336
Objective: To study the efficacy of 50 μg of Misoprostol tablet for induction of labor, oral v/s vaginal
route.
Methods: 100 women, at term gestation, with various indication for induction of labor with Bishop’s
score of ≤4 were included. After deciding, 50 women received 50 μg orally and 50 women received 50
μg vaginally every fourth hourly (maximum of 6 doses) or till they went into active labor.
Results: After statistical analysis it was found that in vaginal misoprostol route the induction to delivery
interval was significantly less compared to oral misoprostol group (9.5 v/s 160).
It was also found that the required dose of drug in vaginal route is less compared to oral route (40% of
women need only 2 doses in vaginal group compared to 35% of oral group were 6 doses required).
Conclusion: For induction of labor vaginal misoprostol is always more effective compared to oral rout
EVALUATION OF EFFICACY AND SAFETY OF MISOPROSTOL FOR CERVICALRIPENINGANDINDUCTIONOFLABOURBYTWODIFFERENTROUTES
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 1866-1869
BACKGROUND: Cervical ripening is one of the methods employed for induction of labour.
Cervicalripening involves the usage of pharmacological agents or other means to soften, efface or
dilate thecervix to increase the likelihood of a vaginal delivery. Induction of labour (IOL) is the
process
ofinitiatingcontractionsinpregnantpersonswhoarecurrentlynotinlabour,tohelpthemachievevaginaldel
ivery within 24 to 48 hours. OBJECTIVE OF THE STUDY: The objective of the study is
tocompare the efficacy and safety of two different routes of regimen of misoprostol for cervical
ripeningand induction of labour. MATERIALS &METHODS: This prospective comparative
study, wasconducted in the Department of Obstetrics and Gynaecology at Adesh Medical College,
for a periodfrom may January 2021 to June 2021. We enrolled 100 patients in our study. We
divided the
patientsintotwogroupsrandomlyintoGroupAandGroupB.GroupAweadministeredmisoprostolvaginal
lyandGroupBsublingually.Thedoseusedforboththegroupswas25μg.RESULTS&CONCLUSIONS:
In our study, we found that there were no statistically significant differences indemographis,
Bishops Score after induction, number of doses required, complications (foetal distress,meconium
stained liquor and hyper stimulation), maternal side effects and neonatal Apgar
Scoresbetweenthetwogroups.Therewerestatisticallyhighlysignificantdifferencesintheneedforoxytoci
naugmentation between the two groups. Oxytocin augmentation was more in group B in patients
ascomparedto patients in group A.
A prospective comparation of outcome of labour induction with vaginal misoprostol and intravenous oxytocin in term pre-labour rupture of membranes
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 2100-2104
Aim and Objectives: The aim of the present study was to assess the safety and efficacy of vaginally administered misoprostol 25mg with intravenous oxytocin for labor induction in term prelabour rupture of membranes.
The subjects with rupture of membranes without labor were assigned to receive either vaginally administered misoprostol 25 micrograms or intravenous oxytocin infusion this prospective study was conducted during February 2014 to January 2016 in the Department of Obstetrics and Gynecology of Regional Institute of Medical Sciences, Imphal, India.
Results and Observation: Of the 192 subjects 96 received intravaginal misoprostol and 96 received intravenous oxytocin It was observed that the average interval from start of induction to delivery was about one hour shorter in misoprostol group (12.58+4.08 hours vs 14.00+3.31 hrs) than in oxytocin group (P=0.05). Vaginal delivery occurred in 82 misoprostol treated group and in 80 oxytocin treated group (85.4% vs 83.3%, P= 0.691).Caesarean section was done in 14 of misoprostol treated subjects and in 16 oxytocin treated subjects (14.6% vs 16.7%) which is not statistically significant.
Conclusion: Vaginal administration of misoprostol is an effective alternative to oxytocin infusion for labor induction in women with prelabour rupture of the membranes at term.
Comparative study of efficacy and safety of mifepristone and Foley’s catheter in induction of labour
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 2521-2528
Background: Labour Induction the most common Obstetric intervention done all over the world and where many methods are experimented for the same. Mifepristone, an antiprogestin effectively used for labour induction in term pregnancies is an upcoming area of interest. Foley’s bulb induction is an ancient and effective method as inducing agent, Misoprostol (PGE1) has been in use more effectively from 1990’s for Induction of labour. Since there is no single novel drug for induction, which is more effective and universally accepted, there is always scope for research. Hence this is a study undertaken to compare Mifepristone and Foley’s bulb in induction of labour.
Objectives:
1. To compare the efficacy and safety of mifepristone and Foley’s catheter insertion in induction of labor.
2. To compare the maternal and fetal outcome in both the groups.
Methodology: Prospective Randomized Control Trial undertaken in 100 pregnant women undergoing labour induction for various indications meeting the inclusion and exclusion criteria. Group A received Mifepristone 200mg PO, followed by 25mcg vaginal misoprostol 4th hourly for maximum of 4 doses and oxytocin accordingly deciding on Bishop’s score, In Group B Foley’s bulb inserted intracervically and inflated with 30ml of distilled water and followed similarly with misoprostol and oxytocin. Change in Bishop’s score, progress of labour induction to delivery interval, successful IOL and neonatal outcome noted.
Results: The primary outcomes were-
1. The improvement in Bishop’s score was similar in Mifepristone and Foley’s bulb group, i.e. 2.80 and 2.88 respectively.
2. Mean induction to delivery interval which is comparatively short in Mifepristone group (20.50hrs) compared to Foley’s bulb group (19.47hrs) and was found to be not statistically significant (P<0.001).
3. Successful IOL-Labour natural was maximum in Mifepristone group-68% compared to 62% in Foley’s group.
Conclusion: Foley’s catheter & Mifepristone are effective agents for cervical ripening which have comparable efficacy and negligible FETO-maternal side effects.
Foley’s Catheter And Vaginal Misoprostol Versus Vaginal Misoprostol Alone For Labour Induction
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 7, Pages 2150-2157
Background- The labour induction becomes necessary when the continuing the pregnancy could result in maternal and fetal complications. Cervical ripening is essential for success of normal delivery, so attempts are made to ripen the cervix in a small span of time.
Aim- To study the comparative impact of “Transcervical Foley's Catheter with vaginal misoprostol on labour induction versus vaginal misoprostol alone” at or after 36 weeks of gestation.
Method- A cross- sectional study conducted in the rural area of India involves 120 full term pregnant females selected by systematic random sampling technique and the labour will be induced either by Foley’s catheter along with misoprostol or misoprostol alone.
Result - In females induced with the Foley catheter along with vaginal misoprostol in both
Primigravida and multigravida females, the time from induction to delivery is predicted to be substantially reduced. Conclusion- Due to synergistic effect of intracervical Foley’s catheter and vaginal misoprostol for cervical ripening and induction of labour, the time from induction to delivery interval will be reduced, prolongation of labour will be decreased and unnecessary caesarian section can be avoided.