THE ROLE OF ORAL PGE1 IN INDUCTION OF LABOUR AND THE OUTCOME OF PREGNANCY

Dr. P. Vijaya, Dr. Sowmya Patnala

Abstract


Objective: It is a prospective randomized study to see the efficacy of PGE1 in cases of PROM from 28wks to term gestational age evaluating the mode of delivery with perinatal and maternal outcome. This study was conducted at Mahavir Institute of Medical Sciences, Vikarabad during 1/1/2018 to 30/12/2018.

Methodology: Women with PROM history with unfavourable cervix misoprostol 25micrograms orally 4th hrly up to a maximum of 6 doses given. Bishops score was assessed and labour augmented using oxytocin as and when required. Contractions monitored with CTG. Vaginal examination done 4-6hrly to assess the progress of labour.

All the women were monitored with continuous CTG. Primary (time interval from induction to delivery, percentage of women delivered within 24 hrs. vaginally, rate of LSCS) and Secondary (need of oxytocin acceleration, neonatal morbidity and mortality, maternal morbidity and mortality) outcomes noted.

Results: Out of 100 cases 81 delivered vaginally, 19 cases LSCS done. In term PROM cases -100% survival. Among preterm PROM 21/100, 2 were IUD on admission, 3 neonatal deaths. Total perinatal mortality 3% in 100 cases of PROM No. of NICU admissions 10/100-10%. According to birth weights IUD babies were 750, 800gms. NND two were<1.2kg. NND 1baby was 1.8kg. Mean birth weight of NND –1.2kg. Birth weight of >1.8kgs all the babies survived.                

Conclusion: PGE1 Misoprostol is effective for cervical ripening and inducing labour in PROM cases as seen in our study with 100% perinatal survival in term PROM and LSCS rate of 19%. In our study we did not have PPH or hyper stimulation.

Hence low dose PGE1 25 micrograms is efficient and cost effective as an inducing agent orally also.

 


Keywords


PROM-preterm rupture of membranes, PG Prostaglandin, PGE1-prostaglandin E1, NICU-neonatal intensive care unit, NND-neonatal death, IUD-intrauterine death, CTG-cardiotocography, LSCS-lower segment caesarean section, FHR-fetal heart Rate, PPH-Post-partum ha

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References


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