Induction of labor in unfavourable cervix: vaginal misoprostol versus vaginal misoprostol with estradiol

*, Raksha M. and Rao, Arun A and Kamath, Anagha and Rao, Bharathi and *, Shameem V.P.A (2013) Induction of labor in unfavourable cervix: vaginal misoprostol versus vaginal misoprostol with estradiol. Int J Pharm Biomed Res, 4 (4). pp. 202-205. ISSN 0976-0350

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Objectives: To compare the safety and effectiveness of vaginal misoprostol v/s combined vaginal misoprostol with estradiol for priming an unfavourable cervix. Methods: Hospital based, randomized study conducted in Lady Goschen Hospital, Mangalore. Women were randomly assigned to receive vaginal misoprostol 25μg or vaginal misoprostol 25μg with vaginal estradiol 50μg. Misoprostol alone was repeated every 6h in both groups till the ripening of the cervix. Cervical evaluation was done using Bishop’s score. A score of < 4 was taken as unfavorable and cervix was considered as ripe when the Bishop’s score > 6. End point of the study was till the ripening of the cervix although evaluation was continued till delivery to record the first dose of administration to delivery interval, mode of delivery and fetal outcome. Inclusion criteria were pregnant women at gestational age >37 weeks with unfavourable cervix, cephalic presentation, singleton pregnancy, pre labour rupture of membranes and PIH. Exclusion criteria were Oligohydramnios, IUGR, previous LSCS and Bishop’s score is between 4 to 6. Statistical analysis was performed using student t test, independent sample t test, Mann-Whitney U test, χ2 test. A p-value of <0.05 was considered significant. Results: Time interval between the administration of the first dose to cervical ripening (p<0.001) and vaginal delivery (p<0.001), number of doses of misoprostol required for cervical ripening (p<0.001), the number of cases of failure of cervical ripening (p=0.009) were found to be lesser in the misoprostol and estradiol group when compared to the misoprostol only group. Conclusion: Estradiol acts synergistically with misoprostol vaginally and significantly hastens the process of cervical ripening, vaginal delivery and also decreases the number of doses of misoprostol required to achieve this.

Item Type: Article
Uncontrolled Keywords: Bishop’s score, Estradiol, Induction, Labor, Misoprostol
Subjects: Medicine > KMC Mangalore > Obstetrics & Gynaecology
Depositing User: KMCMLR User
Date Deposited: 01 Aug 2014 11:08
Last Modified: 01 Aug 2014 11:08

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