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 50
- Downloads 0
EFFECTS OF SEMI-ABLATIVE FRACTIONAL RADIOFREQUENCY IN DERMAL TISSUE.
The use of radiofrequency serves the purpose of improving dermal aging through new collagen fibres formation, making the skin firmer. The objective of this study is to investigate the effects of fractional radiofrequency...
INSERTION C V317RFS*75 WITH FRAME SHIFT MUTATION, WAS SHOWN TO BE MORE FREQUENT IN PINK1 GENE IN SUDANESE PATIENTS.
Introduction: Descriptions of Parkinson\'s disease has been known as far as 5000 BC and is the second most common neurodegenerative disorder after Alzheimer disease, and the most common movement disorder. In 1997, a gene...
FORMULATION AND QUALITY EVALUATION OF COOKIES FROM DRUMSTICK LEAF POWDER AND CAULIFLOWER LEAF POWDER.
In the present fast growing rapidly changing global society, attaining good health has become a challenge for all age groups. Now a day?s Consumption of foods made from the leaves has increased, but still, few are consid...
A STUDY ON ENHANCING EMOTIONAL INTELLIGENCE BY TRANSCENDENTAL MEDITATION ON STUDENTS.
Emotional intelligence refers to the capability of a person to manage and control his or her emotions and possess the ability to control the emotions of others as well. Research studies reveal that one can develop their...
VALIDITY TEST OF LEARNING DEVICES IN THE ASSESSMENT OF ECONOMIC LEARNING OUTCOMES SUBJECT USING CONTEXTUAL TEACHING AND LEARNING (CTL) APPROACH.
The assessment of Economic Learning Outcomes is a subject that must be followed by every student in the economic education department, STKIP PGRI Sumatera Barat. Students do not understand the concepts in the assessment...