COMPARISON OF PROSTAGLANDIN E2 GEL, PROSTAGLANDIN E2 PESSARY AND EXTRA-AMNIOTIC SALINE INFUSION WITH OXYTOCIN FOR INDUCTION OF LABOUR
AbstractBackground: Induction of labour is the intentional initiation of cervical ripening and uterinecontraction for the purpose of accomplishing delivery, prior to onset of spontaneous parturition. Thisstudy was conducted to compare maternal and neonatal outcome in women induced with ProstaglandinE2 gel, Prostaglandin E2 pessary and extra-amniotic saline infusion with oxytocin at Bishops score <5.Methods: It was a quasi-experimental which was conducted at the Department of Gynaecology andObstetrics Unit-I, Mother and Child Health Care Centre, Pakistan Institute of Medical Sciences,Islamabad during one year of time. Eighty cases in each group (prostaglandin gel, prostaglandinE2pessary and extra-amniotic saline infusion with oxytocin) were collected. Systematic sampling wasdone. First woman admitted was induced with prostaglandin gel, the second one with prostaglandinpessary and the third was induced with extra amniotic saline infusion and oxytocin. Results: The mostcommon indication for induction was post dates followed by PIH. The induction labour interval wasless in EASI with oxytocin group (5.18±3.4) hours, as compared to prostaglandin pessary (8.81±5.60)hours and prostaglandin gel (8.32±5.18) hours. Induction delivery interval in EASI with oxytocin was(10±5.6) hours as compared to prostaglandin pessary (14±6.3) hours and prostaglandin gel (13±7.1)hours. This difference was statistically significant. The primigravidas had longer duration of labour thanmultigravidas. Induction labour interval in primigravidas was (8.2±5.1) hours while in multigravidas itwas (6.7±5.02) hours. Induction delivery interval was also more in primigravidas (13.6±6.80) hours ascompared to multigravidas (11.4±6.20) hours. Vaginal delivery rate was 89.2% while the caesareansection rate was 10.4%. The most common indication for caesarean section was foetal distress. Therewas no significant difference in perinatal morbidity and mortality in the three groups. Conclusion:EASI with oxytocin is a better method of induction than prostaglandin E2 gel and pessary. Moreover itis more economical in our country.Keywords: Induction of labour, Bishop score, EASI, Prostaglandin E2
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