Comparison of the efficacy and safety of intracervical dinoprostone gel and intravaginal misoprostol tablet as a cervical ripening agent
Journal Title: International Journal of Medical Science and Public Health - Year 2015, Vol 4, Issue 1
Abstract
Background: Cervical ripening is an important prerequisite for successful induction of labor, a procedure that is frequently necessary because of medical or obstetrical complications. Of several methods of ripening, intracervical dinoprostone gel and intravaginal misoprostol tablet are the most frequently used methods. Aims andObjectives: To compare the ef fi cacy and safety of intracervical dinoprostone gel and intravaginal misoprostol tablet as a cervical ripening agent. Materials andMethods: A total of 138 pregnant women satisfying the inclusion criteria were studied. They were divided into two groups: 72 in group 1 (dinoprostone gel) and 66 in group 2 (misoprostol tablet). The safety and ef fi cacy of both the drugs were analyzed. The primary outcome variables were change in Bishop ’ s score, induction to delivery (I-D) time, Apgar score, and incidence of abnormal uterine action. The secondary outcome variables were need for oxytocin, indication for caesarean section, and mode of delivery. Statistical analysis was done using the unpaired t -test and w 2 -test. Results: No difference was observed between the two groups with respect to change in Bishop ’ s score (3.015 vs 3.625, p 4 0.05), but I-D time was more for group 1 (i.e., 15.04 vs 11.48 h, p o 0.05). Apgar scores were also similar in both the groups, that is, the number of babies with Apgar score of o 8 at 5 min was 3 for group 1 vs 6 for group 2, p 4 0.05. Abnormal uterine action was not seen at all in group 1, whereas three patients had this problem in group 2. In secondary variables, requirement of oxytocin was more in group 1 (i.e., 48 vs 22, p o 0.05). In various indications of caesarean section, none got operated for abnormal uterine action in group 1, whereas three patients got operated for this reason in group 2. Mode of delivery was similar in both the groups. Conclusions: Dinoprostone and misoprostol are similar in their action on cervical ripening. Misoprostol has an added bene fi t of being a uterotonic agent. Therefore, it has less I-D time. Low-dose of misoprostol has decreased the incidence of side effects
Authors and Affiliations
Shobha Mukherjee, Sujoy Mukherjee
A clinical study of pattern, complications, and visual outcome of viral keratitis
Background: Herpes simplex viral (HSV) keratitis typically presents as an infection of the superficial layer of the cornea, with punctate or diffuse branching (dendritic) lesions of the epithelium that do not usually inv...
Clinico-epidemiological profile of patients with febrile illness attending malaria clinic at medical college hospital of Surat, Gujarat, India
Background: Febrile illnesses are pre-eminent contributors to morbidity and mortality. As one of the common cause, malaria is a potentially life threatening parasitic disease. Passive surveillance of malaria is ca...
A study of variations of subclavian artery and its clinical implication
Background: When the right subclavian artery directly arises from the arch of aorta (AOA) distal to the origin of the left subclavian artery, it is known as an aberrant right subclavian artery (ARSCA). It is a most commo...
Plasma and urinary matrix metalloproteinase-9 as a marker for detection of nephropathy in type 2 diabetic patients
Background: Diabetic nephropathy (DN) is a serious complication in diabetes and now it has become the most common cause of end-stage renal disease (ESRD). Development of diabetic nephropathy is characterized by a thi...
Management of comminuted extraarticular inferior pole patella fractures with partial patellectomy and patellar tendon repair by transosseous sutures
Background: Lower pole patella fractures are not uncommon and are often comminuted and not amenable to traditional fixation methods as difficult to reduce and fix. Optimal method of treatment is still debatable. We prese...