Premature rupture of the membranes (PROM) occurs in about 8-10% of pregnancies and its most important complication is chorioamnionitis, so labour induction has an important role in this situation. This study was performed to compare oxytocin and sublingual Misoprostol for labour induction in PROM cases with term pregnancy. A total of 270 pregnant women who had spontaneous rupture of membrane and unripe cervix were enrolled. The first group underwent Oxytocin infusion according to low-dose standard protocol and the second group received 25 μg sublingual Misoprostol every 4 h. Time interval from induction to the beginning of active phase of labour was similar in both groups. Second stage of labour was significantly shorter in misoprostol group (p < .05). Although, some maternal side-effects were significantly higher in misoprostol group (p < .001), but 5 minute Apgar score was significantly better in this group. In conclusion, sublingual misoprostol was associated with better neonatal outcomes was more effective than oxytocin for labour induction in PROM cases. Impact statement What is already known on this subject: PROM occurs in about 8-10% of pregnancies; about 60% of these cases are term pregnancies. Most experts recommend early induction of labour in term PROM cases with an eye towards avoiding increased morbidity and mortality. Oxytocin is the most frequently used agent that is administered intravenously for the purpose of labour induction. Misoprostol is an alternative to oxytocin and is simpler to use, as it is administered via the oral, buccal, sublingual, rectal and vaginal routes rather than intravenously. What do the results of this study add: Time interval from induction to the beginning of active phase of labour was similar in both groups. Second stage of labour was significantly shorter in the misoprostol group. Although, some maternal side-effects were significantly higher in misoprostol group, the 5 minute Apgar score was significantly better in this group. What are the implications of these finding for clinical practice and/or further research: Sublingual misoprostol for induction of labour in PROM cases is more effective than oxytocin and its neonatal outcomes are better. Due to its easy prescription and better labour outcomes, sub lingual misoprostol may be a better choice for labour induction in PROM cases.
Introduction: Pure non-gestational ovarian choriocarcinoma is a rare malignant condition with aggressive behavior. The tumor arises from germ cells of ovarian. Few cases have been reported in the literature. We present a case of pure ovarian choriocarcinoma with disseminated tumor in pelvic. Case Presentation: A 16-year-old girl was referred to Ghaem hospital, Mashhad University of Medical Sciences, Mashhad, Iran in April 2016 with acute abdominal pain, abdomino pelvic mass and vaginal bleeding. In addition, an extremely high level of sub unit of human chorionic gonadotropin β-hCG was detected. Based on the emergency condition, she underwent laparotomy and left salpingo-oophorectomy with suboptimal resection of the tumor. Histopathology revealed a tumor compatible with pure nongestational ovarian choriocarcinoma. Adjuvant chemotherapy was performed based on 4 courses of bleomycin-etoposide-cisplatin (BEP) regimen. She is now under chemotherapy. Conclusions:We recommend the use of minimally invasive, fertility-preserving surgeries in patients with non-gestational ovarian choriocarcinomas.
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