Background: Misoprostol has been used for medical abortion. We conducted this prospective study to see the efficacy of oral misoprostol in our tertiary Hospital. Objective: Objective of this study was to assess the ef...Background: Misoprostol has been used for medical abortion. We conducted this prospective study to see the efficacy of oral misoprostol in our tertiary Hospital. Objective: Objective of this study was to assess the efficiency, safety and compliance of misoprostol in first trimester abortion. Materials and Methods: This prospective study was undertaken in obstetrics and gynecology dept of CMH Dhaka, Bangladesh from July 2014 up to Dec 2014. A total 50 patients of incomplete abortion (54%), missed abortion (30%), anembryonic pregnancy (14%) and inevitable abortion (2%) of s of gestation were the targeted population. Study population was diagnosed from history, physical examination and ultrasonogram had received 600 microgram misoprostol orally. If the pregnancy was not completely evacuated at this time another dose of misoprostol was given. All women returned for follow-up care 7 days later. If the pregnancy was not completely evacuated at this time, women underwent immediate surgical evacuation. Efficacy was defined as the percent of women discharged from the study without need for surgical intervention. Results: 30 patients had complete evacuation after 1st dose, 12 cases needed 2nd dose and only 2 cases needed 3rd dose. Remaining 6 cases needed surgical evacuation. Efficacy was satisfactory (85%) and analysis revealed statistically significant (p 0.05). Conclusion: Management of first trimester abortion with oral misoprostol is highly effective and highly acceptable.展开更多
The objective of this study was to assess the efficacy and safety of the 2 hourly oral misoprostol for labor induction. Between May and November 2013, the hospital records of 83 women who were induced for labor and me...The objective of this study was to assess the efficacy and safety of the 2 hourly oral misoprostol for labor induction. Between May and November 2013, the hospital records of 83 women who were induced for labor and met the eligibility criteria were retrospectively reviewed. Eligibility criteria were singleton pregnancy of at least 34 weeks’ gestation and a baseline Bishop score 6. Women with a previous cesarean section or other uterine surgery, severe pregnancy-induced hypertension, and parity of 4 or more were excluded. Oral misoprostol was administered as 20 μg 2 hourly unless active labor. A maximum of 12 doses was allowed. The age of the women was 27.9 ± 5.3 years (mean ± SD). Vaginal delivery within 24 hours occurred in 38 (45.8%) women. Cesarean delivery occurred in 17 (20.5%) women. Although more parous women achieved vaginal delivery within 24 hours (52.6%) compared with nulliparous women (40.0%), the difference was not significant (P = .35). Uterine tachysystole occurred in 12 (14.5%) women. No perinatal deaths or neonatal intensive care unit admission occurred in the study group. Evidence supporting an optimal regimen is lacking, and additional research is warranted to optimize the use of oral misoprostol for the induction of labor.展开更多
Objective: To compare labor induction with transcervical catheter to oral misoprostol treatment in primiparous women and women with an unripe cervix, who are at high risk for unsuccessful labor induction. Study Design...Objective: To compare labor induction with transcervical catheter to oral misoprostol treatment in primiparous women and women with an unripe cervix, who are at high risk for unsuccessful labor induction. Study Design: A retrospective study was carried out in a university hospital in Sweden. Primary outcomes were vaginal birth within 24 hours and the cesarean section rate. Secondary outcomes were the induction to vaginal delivery interval, chorioamnionitis and neonatal asphyxia. Results: Vaginal birth within 24 hours was obtained more frequently after catheter compared with misoprostol in primiparous women (p < 0.001) and women with Bishop scores 3 - 4 (p < 0.001), but not in women with Bishop scores 0 - 2 (p = 0.07). The cesarean section rates were comparable in all groups (p > 0.05). The induction to vaginal delivery interval was 8 - 12 hours shorter after catheter (p < 0.001). The rates of chorioamnionitis and newborns with an Apgar score 0.05). Conclusion: Labor induction with transcervical catheter resulted in a higher rate of vaginal birth within 24 hours and an 8 - 12 hour shorter induction to vaginal delivery interval compared to treatment with oral misoprostol. This was obtained without increasing the rates of cesarean section, chorioamnionitis or neonatal asphyxia.展开更多
Background: Labour induction is one of the most common medical procedures in obstetrics. The aim is to end the pregnancy when continuity is a risk to mother or fetus. Its main side effect is the increase in the cesare...Background: Labour induction is one of the most common medical procedures in obstetrics. The aim is to end the pregnancy when continuity is a risk to mother or fetus. Its main side effect is the increase in the cesarean rate, compared to spontaneous onset deliveries. On the other hand, mortality and morbidity in cesareans are higher. The most common pharmacological drugs used for induction are prostaglandins: dinoprostone and misoprostol. The “gold standard” for labour induction is vaginal misoprostol. The oral route is also effective and also has several benefits like faster onset and easear administration. In recent years several publications state that the administration of misoprostol oral solution, given in doses gradually, is associated with a lower cesarean and hyperstimulation rate than the cases where vaginal misoprostol has been used in pregnant women with unripe cervix. Furthermore, being its half life shorter, it may be very useful in case of uterine hyperstimulation and, probably, a high percentage of women prefer this oral administration to the vaginal one. The objective of this study is to compare the efficacy, safety and side effects on mother and fetus on use of oral versus vaginal administration for induction of labour for prolonged gestation (41 weeks) and premature rupture of membranes, both with live fetus. Methods/Design: Design: double blind controlled trial. Study population: Pregnant women whose labour will be induced due to premature rupture of membranes or prolonged gestation. Inclusion Criteria: 1) Bishop Test equal to or less than 7;2) Single pregnancy;3) Pregnancy at term (37 - 42 weeks);4) No history of uterine surgery;5) Cephalic presentation;6) Live fetus;7) No prostaglandins contraindications. Discussion: Nowadays induction rates are very high, ranging from 25% to 30% approximately. In these cases caesarean rates are higher than when the delivery starts spontaneously. That is one of the main reasons why caesareans have increased, mainly in the cases of nuliparous women with immature cervix. If we can prove the hypothetical good results obtained through the use of dosed oral misoprotol, we will be able to reduce the number of induced deliveries by cesarean, and so improve the levels of security for the mother and the foetus, and, as a consequence, provide a higher quality of medical attention to the newborn and the mother.展开更多
目的:探讨口服米索前列醇溶液和欣普贝生用于宫颈条件不成熟的妊娠期高血压孕妇引产的有效性和安全性。方法:回顾分析2022年10月至2023年5月河北省人民医院收治的63例需终止妊娠的宫颈评分<6分的妊娠期高血压孕妇,其中30例给予口服...目的:探讨口服米索前列醇溶液和欣普贝生用于宫颈条件不成熟的妊娠期高血压孕妇引产的有效性和安全性。方法:回顾分析2022年10月至2023年5月河北省人民医院收治的63例需终止妊娠的宫颈评分<6分的妊娠期高血压孕妇,其中30例给予口服米索前列醇溶液促宫颈成熟,33例给予欣普贝生促宫颈成熟。收集并比较两组孕妇的产程、分娩方式、中转剖宫产率,以及产钳率、侧切率、产后出血率、转入新生儿监护病房等。结果:米索前列醇组的宫颈成熟时间和引产时间均长于欣普贝生组[(32.77±20.37)h vs (16.09±16.42)h,P=0.07;(39.15±28.21)h vs (11.57±8.56)h,P=0.019]。米索前列醇组和欣普贝生组24h内阴道分娩者分别是12.00%和84.44%,需联合其他引产方法者分别占43.33%和4.76%,差异均有统计学意义(P<0.001)。两者的产程、中转剖宫产率、产钳率、侧切率、产后出血率、新生儿入住新生儿监护病房等比较,差异无统计学意义(P>0.05)。与欣普贝生组比较,米索前列醇组因胎儿窘迫行剖宫产率显著降低(P=0.04,RR=0.25,95%CI为0.07~0.98),因可疑感染行剖宫产率显著升高(P=0.01,RR=3.01,95%CI为1.36~6.93),子宫过度刺激发生风险明显降低(P=0.001,RR为0.26,95%CI为0.08~0.74)。结论:妊娠期高血压孕妇需引产促宫颈成熟时,口服低剂量的米索前列醇溶液安全有效,但引产时间较长,24h内分娩率低,且需联合其他促宫颈成熟方法。展开更多
文摘Background: Misoprostol has been used for medical abortion. We conducted this prospective study to see the efficacy of oral misoprostol in our tertiary Hospital. Objective: Objective of this study was to assess the efficiency, safety and compliance of misoprostol in first trimester abortion. Materials and Methods: This prospective study was undertaken in obstetrics and gynecology dept of CMH Dhaka, Bangladesh from July 2014 up to Dec 2014. A total 50 patients of incomplete abortion (54%), missed abortion (30%), anembryonic pregnancy (14%) and inevitable abortion (2%) of s of gestation were the targeted population. Study population was diagnosed from history, physical examination and ultrasonogram had received 600 microgram misoprostol orally. If the pregnancy was not completely evacuated at this time another dose of misoprostol was given. All women returned for follow-up care 7 days later. If the pregnancy was not completely evacuated at this time, women underwent immediate surgical evacuation. Efficacy was defined as the percent of women discharged from the study without need for surgical intervention. Results: 30 patients had complete evacuation after 1st dose, 12 cases needed 2nd dose and only 2 cases needed 3rd dose. Remaining 6 cases needed surgical evacuation. Efficacy was satisfactory (85%) and analysis revealed statistically significant (p 0.05). Conclusion: Management of first trimester abortion with oral misoprostol is highly effective and highly acceptable.
文摘The objective of this study was to assess the efficacy and safety of the 2 hourly oral misoprostol for labor induction. Between May and November 2013, the hospital records of 83 women who were induced for labor and met the eligibility criteria were retrospectively reviewed. Eligibility criteria were singleton pregnancy of at least 34 weeks’ gestation and a baseline Bishop score 6. Women with a previous cesarean section or other uterine surgery, severe pregnancy-induced hypertension, and parity of 4 or more were excluded. Oral misoprostol was administered as 20 μg 2 hourly unless active labor. A maximum of 12 doses was allowed. The age of the women was 27.9 ± 5.3 years (mean ± SD). Vaginal delivery within 24 hours occurred in 38 (45.8%) women. Cesarean delivery occurred in 17 (20.5%) women. Although more parous women achieved vaginal delivery within 24 hours (52.6%) compared with nulliparous women (40.0%), the difference was not significant (P = .35). Uterine tachysystole occurred in 12 (14.5%) women. No perinatal deaths or neonatal intensive care unit admission occurred in the study group. Evidence supporting an optimal regimen is lacking, and additional research is warranted to optimize the use of oral misoprostol for the induction of labor.
文摘Objective: To compare labor induction with transcervical catheter to oral misoprostol treatment in primiparous women and women with an unripe cervix, who are at high risk for unsuccessful labor induction. Study Design: A retrospective study was carried out in a university hospital in Sweden. Primary outcomes were vaginal birth within 24 hours and the cesarean section rate. Secondary outcomes were the induction to vaginal delivery interval, chorioamnionitis and neonatal asphyxia. Results: Vaginal birth within 24 hours was obtained more frequently after catheter compared with misoprostol in primiparous women (p < 0.001) and women with Bishop scores 3 - 4 (p < 0.001), but not in women with Bishop scores 0 - 2 (p = 0.07). The cesarean section rates were comparable in all groups (p > 0.05). The induction to vaginal delivery interval was 8 - 12 hours shorter after catheter (p < 0.001). The rates of chorioamnionitis and newborns with an Apgar score 0.05). Conclusion: Labor induction with transcervical catheter resulted in a higher rate of vaginal birth within 24 hours and an 8 - 12 hour shorter induction to vaginal delivery interval compared to treatment with oral misoprostol. This was obtained without increasing the rates of cesarean section, chorioamnionitis or neonatal asphyxia.
文摘Background: Labour induction is one of the most common medical procedures in obstetrics. The aim is to end the pregnancy when continuity is a risk to mother or fetus. Its main side effect is the increase in the cesarean rate, compared to spontaneous onset deliveries. On the other hand, mortality and morbidity in cesareans are higher. The most common pharmacological drugs used for induction are prostaglandins: dinoprostone and misoprostol. The “gold standard” for labour induction is vaginal misoprostol. The oral route is also effective and also has several benefits like faster onset and easear administration. In recent years several publications state that the administration of misoprostol oral solution, given in doses gradually, is associated with a lower cesarean and hyperstimulation rate than the cases where vaginal misoprostol has been used in pregnant women with unripe cervix. Furthermore, being its half life shorter, it may be very useful in case of uterine hyperstimulation and, probably, a high percentage of women prefer this oral administration to the vaginal one. The objective of this study is to compare the efficacy, safety and side effects on mother and fetus on use of oral versus vaginal administration for induction of labour for prolonged gestation (41 weeks) and premature rupture of membranes, both with live fetus. Methods/Design: Design: double blind controlled trial. Study population: Pregnant women whose labour will be induced due to premature rupture of membranes or prolonged gestation. Inclusion Criteria: 1) Bishop Test equal to or less than 7;2) Single pregnancy;3) Pregnancy at term (37 - 42 weeks);4) No history of uterine surgery;5) Cephalic presentation;6) Live fetus;7) No prostaglandins contraindications. Discussion: Nowadays induction rates are very high, ranging from 25% to 30% approximately. In these cases caesarean rates are higher than when the delivery starts spontaneously. That is one of the main reasons why caesareans have increased, mainly in the cases of nuliparous women with immature cervix. If we can prove the hypothetical good results obtained through the use of dosed oral misoprotol, we will be able to reduce the number of induced deliveries by cesarean, and so improve the levels of security for the mother and the foetus, and, as a consequence, provide a higher quality of medical attention to the newborn and the mother.
文摘目的:探讨口服米索前列醇溶液和欣普贝生用于宫颈条件不成熟的妊娠期高血压孕妇引产的有效性和安全性。方法:回顾分析2022年10月至2023年5月河北省人民医院收治的63例需终止妊娠的宫颈评分<6分的妊娠期高血压孕妇,其中30例给予口服米索前列醇溶液促宫颈成熟,33例给予欣普贝生促宫颈成熟。收集并比较两组孕妇的产程、分娩方式、中转剖宫产率,以及产钳率、侧切率、产后出血率、转入新生儿监护病房等。结果:米索前列醇组的宫颈成熟时间和引产时间均长于欣普贝生组[(32.77±20.37)h vs (16.09±16.42)h,P=0.07;(39.15±28.21)h vs (11.57±8.56)h,P=0.019]。米索前列醇组和欣普贝生组24h内阴道分娩者分别是12.00%和84.44%,需联合其他引产方法者分别占43.33%和4.76%,差异均有统计学意义(P<0.001)。两者的产程、中转剖宫产率、产钳率、侧切率、产后出血率、新生儿入住新生儿监护病房等比较,差异无统计学意义(P>0.05)。与欣普贝生组比较,米索前列醇组因胎儿窘迫行剖宫产率显著降低(P=0.04,RR=0.25,95%CI为0.07~0.98),因可疑感染行剖宫产率显著升高(P=0.01,RR=3.01,95%CI为1.36~6.93),子宫过度刺激发生风险明显降低(P=0.001,RR为0.26,95%CI为0.08~0.74)。结论:妊娠期高血压孕妇需引产促宫颈成熟时,口服低剂量的米索前列醇溶液安全有效,但引产时间较长,24h内分娩率低,且需联合其他促宫颈成熟方法。
