COMPARATIVE STUDY OF CERVIPRIME GEL WITH ORAL MISOPROSTOL IN INDUCTION OF LABOUR FOR POST DATISM AND PIH AND IUGR

DR.RATHINAMALA BALASUBRAMANIYAN; DR.GAYATHRIE DEVI SELLATHAMBY

Volume : VII, Issue : IX, September - 2017

COMPARATIVE STUDY OF CERVIPRIME GEL WITH ORAL MISOPROSTOL IN INDUCTION OF LABOUR FOR POST DATISM AND PIH AND IUGR

Dr. Rathinamala Balasubramaniyan, Dr. Gayathrie Devi Sellathamby

Abstract :

BACKGROUND:

Induction of labour implies the artificial initiation of uterine contraction after the period of viability by medical or surgical method for the purpose of vaginal delivery. It is an intervention that artificially initiates uterine contraction leading to progressive dilatation and effacement of cervix and expulsion of fetus prior to spontaneous onset of labour. It is indicated if the continuation of pregnancy is a risk either to the mother or fetus.Comparative study for the effect of oral misoprostol and cerviprime gel in induction of labour for post datism, PIH and oligohydromnios.

MATERIALS AND METHODS: A Prospective observational study of cerviprime gel and oral misoprostol solution was conducted in the department of obstetrics and gynaecology, government KAPV medical college in 100 patients from jan 2017 to march 2017.

The patients were distributed in two groups:

GROUP–1: 50 patients who underwent induction with oral misoprostol solution administered two hours apart.

GROUP 2: 50 patients who underwent induction with dinoprostone intra cervical gel (cerviprime)

Patients recruited in the study were primi gravida at term with obstetrics or medical indication for labour induction. These pts were either booked attending antenatal clinic regularly (had atleast 3 antenatal visits) or emergency admission in labour room.

RESULTS: Out of 100 patients who met with the inclusion and exclusion criteria were subjected to PGE1 (oral misoprostol) and PGE2 (dinoprostone gel) and the results were, the cases induced with PGE2 (DINOPROSTONE) as compared to PGE1(misoprostol) were associated with significantly shorter duration of initiation of labour after induction(table 1),shorter induction to delivery interval (table 2) and higher incidence of vaginal deliveries within first 24 hours (table 3). cerviprime gel is very much effective in achieving normal vaginal delivery within 24 hours. Less caesarean section rate (table 3 & 4) and lower uterine hyperstimulation syndrome with cerviprime gel. The most common indication for LSCS in misoprostol group was fetal distress and that in dinoprostone group was failed induction .

CONCLUSION: In this prospective observational study,50 cases induced with PGE1 were compared with 50 others induced by PGE2 which served as control. The cases induced with PGE2 as compared to PGE1 tablets were associated with higher incidence of vaginal deliveries within the first 24 hrs of induction and significantly shorter induction to delivery interval.Thus in conclusion, PGE2 gel appears to be safer and more efficacious for induction of labour as compared to misoprostol oral tablets.