MISOPROSTOL INDUCTION OF LABOR IN MULTIPARA PREGNANT WOMEN: A MINI-SURVEY FOR PREDICTORS OF OUTCOME.
Journal Title: International Journal of Advanced Research (IJAR) - Year 2018, Vol 6, Issue 4
Abstract
Objectives: To evaluate dose-related outcome of induction of labor (IOL) using misoprostol vaginal inserts (MVI) in multipara pregnant women so as to determine the appropriate dose for getting trial success defined as having vaginal delivery (VD) within 24-hr induction-to-delivery (ITD) interval. Patients & Methods: 644 pregnant women underwent clinical evaluation and vaginal examination to determine Bishop score using the Simplified Bishop Score (SBS). All women received 25 ?g MVI only once and were monitored for labor progress as judged by SBS and uterine contractions with fetal heart monitoring. In absence of fetal distress manifestations and membranes were still intact, but uterine contractions occurred <3 times/10 minutes, another MVI was used for a maximum of 6 doses. Uterine contraction augmentation was provided as amniotomy or/and oxytocin infusion started 4-hrs after the last MVI was placed. Study outcomes included trail success rate, number of MVI used, frequency and mode of augmentation and delivery assistance. Results: 530 women (82.3%) had VD; 159 women without augmentation, 182 women had amniotomy, 105 women received oxytocin drip and 84 women required both. Only 168 women (26.1%) had instrumentally-assisted VD. Mean ITD interval was 10.9?6.3 hr; 492 women had ITD interval <24 hr for a trial success rate of 76.4%. Cesarean section was indicted in 114 women (17.7%). Only 29 women received four, 71 three, 93 two, while 451 women received one MVI, VD rate was significantly (p<0.00001) lower among women received higher number of MVI. Statistical analyses defined high MVI dose and BMI as negative, while high parity is a positive significant predictor for trial success. High MVI dose and BMI are positive, while high SBS and high parity are negative significant predictors for long ITD interval. Kaplan-Meier regression analysis defined the appropriate MVI for IOL trial success at a mean dose of 1.5?0.039 (95% CI: 1.4-1.55). Conclusion: MVI is a satisfactory modality for IOL trial in multipara pregnant women with VD rate of 82.3% and ITD interval of <24-hr in 76.4%. Lower BMI and higher number of previous VD indicate higher possibility of trial success. SBS is appropriate for women selection for trial and follow-up and can predict outcome if combined with BMI, parity and number of MVI used.
Authors and Affiliations
Ayman A. Shedid, Hesham M. Abo Ragab.
Keywords
Related Articles
- EP ID EP290422
- DOI 10.21474/IJAR01/6941
- Views 72
- Downloads 0
ORIGIN, EXPANSION AND ABOLITION OF NARAYANI COIN OF THE PRINCELY STATE OF COOCH BEHAR.
The Cooch Behar State was one of the mighty indigenous of India. The state had immense importance in ancient and medieval history of India. The Maharaja of Cooch Behar ruled the state for hundred years. The former Cooch...
A CASE REPORT- SCORPION BITE WITH AUTONOMIC DYSFUNCTION AND MYOCARDIAL ISCHEMIA.
International Journal of Advanced Research (IJAR)
ANTHROPOMETRIC MEASUREMENTS IN WOMEN WITH POLYCYSTIC OVARY SYNDROME IN SAUDI ARABIA.
Background: Polycystic Ovary Syndrome is a common endocrine disorder that is characterized by the presence of chronic anovulation, excess levels of androgen as well as polycystic ovary on ultrasonographic imaging. Object...
A SURVEY STUDY FOR VITAMIN D DEFICIENCY IN HEALTHY FEMALES IN KARBALA CITY FROM 3RD TO 6TH DECADE.
Background: Vitamin D , also known as the sunshine Vitamin , is produced by the body as a response to sun exposure , it can also be consumed in food or supplements (1). Vitamin D play?s an important roles in maintaining...
EVALUATE THE NEED OF TRAINING AND DEVELOPMENT FOR THE EMPLOYEE SKILLS DEVELOPMENT: A SECONDARY RESEARCH OF PRIVATE BANKING SECTOR IN INDIA.
The Banking sector undergoes a sea level changes with respect to the world?s economic situation irrespective of the economical status of the country. The challenges it faces shapes the way it behaves in the last few deca...