Methods of induction of labor in intrauterine fetal demise: a comparative study

Maheshwari, Saurav; Borgohain, Deepa

doi:10.18203/2320-1770.ijrcog20174033

Cited by 4 publications

(4 citation statements)

References 2 publications

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“…Augmentation with oxytocin was required in 11.5% of women in group II, but no oxytocin was required within the combination group which was against our results. 13 Our results were not consonant with Maheshwari et al 15 who found that more cases required augmentation with oxytocin in group II than group I; however, the difference decided to be nonsignificant statistically.…”

Section: Resultscontrasting

confidence: 54%

“…13,14 The mean number of doses of misoprostol administered to women in the present study was less in the combination group in comparison with the misoprostol group and this finding is in harmony with the studies. [15][16][17] They concluded that pretreatment with mifepristone decreased the number of doses of misoprostol required for women to go into labor. We found a significant decrease in the requirement of misoprostol with prior use of mifepristone that is consistent with the literature that shows decreased prostaglandin requirement in cases where mifepristone was given and also owing to the effective cervical ripening by prior administration of mifepristone.…”

Section: Discussionmentioning

confidence: 99%

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A Prospective Comparative Study of Mifepristone and Misoprostol vs Misoprostol Alone for Induction of Labor in Intrauterine Fetal Death

Hoda¹,

Ali²,

Kulsoom³

2022

Journal of South Asian Federation of Obstetrics and Gynaecology

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Introduction: Intrauterine fetal death (IUFD) is an important indicator of maternal and perinatal health of a given population. Aim and objective: The objective of the study was to assess the efficacy of mifepristone and misoprostol vs misoprostol alone for induction of labor in IUFD and to determine risk-benefit ratio. Materials and methods:The present study was a prospective observational analytical study which was conducted in the Department of Obstetrics and Gynecology, JNMCH, Aligarh, from January 2018 to January 2021and includes 110 pregnant women with confirmed IUFD on USG. After taking informed consent, a predesigned pro forma was used to collect relevant sociodemographic profile, detailed logical history, and examination from all those participating in the study. Results: Age (mean ± SD) was 25.98 ± 4.49 vs 25.69 ± 4.78 years, parity was 2.31 ± 1.3 vs 2.44 ± 1.61, and gestational age was 31.04 ± 6.89 vs 32.71 ± 5.17 weeks in group I and group II, respectively. Modified Bishops score was >6 in 35 (63.64%) vs 32 (14.55%) women, mean dose of misoprostol required was 0.95 ± 1.5 vs 2.64 ± 1.89, mean induction labor interval was 2.42 vs 7.53 hours, and mean induction to delivery interval was 6.68 vs 16.61 hours in group I and group II, respectively, and the difference was found to be statistically significant. Mean birth weight was 1431.35 vs 1758.60 g, respectively, in the two groups. Four women (7.27%) in group I and 17 women (30.9%) in group II required augmentation with oxytocin which is statistically significant. Nausea, vomiting, loose stools, and hyperthermia were recorded as adverse effects. Among the identifiable causes, abruption was the most common cause in group II, whereas anemia and preeclampsia in group I. Conclusion:The combination of mifepristone with misoprostol was more effective for the induction of labor in IUFD, in terms of lesser amount of misoprostol dosage, oxytocin augmentation, improvement in modified Bishops score, and shorter induction labor and delivery interval when compared to misoprostol alone. Both the regimens were equally safe and easy to administer.

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Section: Resultscontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

A Prospective Comparative Study of Mifepristone and Misoprostol vs Misoprostol Alone for Induction of Labor in Intrauterine Fetal Death

Hoda¹,

Ali²,

Kulsoom³

2022

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…The difference was considered to be statistically significant with a p-value of 0.0096. In the study by Maheshwari S and Borgohain D, 6 the active phase from the onset of induction interval in group I was 13.42 ± 4.67 hours. In the study by Raghavan JV et al, 7 mean induction to active-phase interval with dinoprostone was 11.8 ± 5.855 hours.…”

Section: Discussionmentioning

confidence: 91%

Efficacy and Safety of Mifepristone Followed by Vaginal PGE1 vs PGE2 Gel Alone for Induction of Labor in Late Intrauterine Fetal Demise

Garg,

Yadav,

Agarwal

et al. 2023

Journal of South Asian Federation of Obstetrics and Gynaecology

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Objective: To compare the efficacy and safety of mifepristone followed by vaginal misoprostol vs dinoprostone gel alone in induction of labor in late intrauterine fetal demise. Methods: We conducted a randomized controlled study in 70 patients in tertiary care center from October 2020 to March 2022. In group I, 35 women were induced by using mifepristone (200 mg) orally followed by misoprostol. The dose was 100 µg per vaginal in patients with less than 37 weeks of gestation every 4 hourly and 50 µg in patients with more than 37 weeks of gestational age. In women with previous lower segment cesarean section, one dose was of 50 µg of misoprostol. In group II, 35 women were induced by intravaginal PGE 2 (dinoprostone) gel 0.5 mg intravaginally (maximum two doses in 24 hours). Oxytocin was given in both groups for augmentation when needed. Results:The mean induction delivery interval in group I was 10.67 ± 6.751 hours and in group II was 14.51 ± 5.338 hours. Mean induction delivery interval was significantly shorter in the combined regimen than dinoprostone gel-alone group (p-value=0.0103). Conclusion:To conclude our regimen using mifepristone and misoprostol for induction of labor is an effective, less invasive, and safe combination. It results in shorter induction-to-delivery interval than dinoprostone gel.

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“…In the misoprostol group, side symptoms like fever and shivering were more common than in the combined therapy group. [17,18]. According to Panda et al [19], the two groups did not differ significantly regarding complications suffered during labour and delivery.…”

Section: Discussionmentioning

confidence: 92%

A comparative study of second trimester termination of pregnancy with mifepristone and misoprostol vs misoprostol alone in 50 cases

Swathi¹,

Andallu

Balasaraswathi

et al. 2022

Eureka: HS

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The aim: To study the efficacy and safety of combined mifepristone and misoprostol used in second-trimester abortion(≥ 12 and ≤ 20 weeks) in comparison with only vaginal misoprostol. Materials and methods: This study was a prospective comparative randomised clinical study in women attending hospitals in need of a second-trimester abortion, i.e., 12–20 weeks of pregnancy were taken up and divided as Group A – 50 women with mifeprisptone and misoprostol, Group B – 50 women with misoprostol alone Results were analysed according to age, parity, gestational age, average dose of misoprostol required for complete abortion, Induction abortion interval, completeness of abortion, side effects and mean days of hospital stay. Results: Demographic details are comparable and insignificant in the comparison. The average dose of misoprostol (mcg) required for the completeness of abortion in group A is 596±28.28 mcg, and in group B, it is 1148±160.66 mcg (p<0.001) which is statistically significant. In the present study, the induction abortion interval is significantly less in group A compared to group B, with p<0.001. In addition, 10 out of 50 patients in group A aborted within 7 hours, whereas none in group B. Mean duration of hospital stay in group A is 24 hours. In group B, it is 34.82 hours which is statistically significant with a p-value of <0.001. 12 patients in group A and 26 in group B had side effects like nausea, vomiting, fever, headache and diarrhoea. 8 % of group A and 20 % of group B had a fever. These patients were treated with antipyretics. 6 % in group A and 14 % in group B had nausea and vomiting and were treated with antiemetics. 4 % in group A and 8 % in group B had diarrhoea and were treated with antimotility drugs. 6 % in group A and 10 % in group B had a headache; these patients were treated with NSAIDs. Conclusions: The combination of mifepristone and misoprostol is a highly effective and safe method for second-trimester termination of pregnancy. The amount of misoprostol needed to accomplish the abortion, and the severity of the adverse effects are lower in the mifepristone-primed group than in the misoprostol-alone group. Since there are fewer difficulties, this approach can be employed in hospitals with high patient density.

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Methods of induction of labor in intrauterine fetal demise: a comparative study

Cited by 4 publications

References 2 publications

A Prospective Comparative Study of Mifepristone and Misoprostol vs Misoprostol Alone for Induction of Labor in Intrauterine Fetal Death

A Prospective Comparative Study of Mifepristone and Misoprostol vs Misoprostol Alone for Induction of Labor in Intrauterine Fetal Death

Efficacy and Safety of Mifepristone Followed by Vaginal PGE1 vs PGE2 Gel Alone for Induction of Labor in Late Intrauterine Fetal Demise

A comparative study of second trimester termination of pregnancy with mifepristone and misoprostol vs misoprostol alone in 50 cases

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