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Category: Volume 06 Issue 01 January 2018
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Title: Comparative Study of Induction of Labour with Misoprostol versus Foley's Balloon Catheter with Extra Amniotic Saline Infusion in Unfavourable Cervix

Authors: Rachel Alexander, Thanku Thomas Koshy

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.83

Abstract

Background: Induction of labour by use of artificial means improves the obstetric outcome in complicated cases. This observational study compares the effect of prostaglandin E1 (PGE1) and extra amniotic saline infusion (EASI) for pre-labour ripening of unfavourable uterine cervix.

Materials and Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Government TD Medical College, Alappuzha, Kerala. Data were collected from 232 antenatal women with gestational age ≥37 weeks and who satisfied the inclusion and exclusion criteria were included in this study. 232 patients were divided into two groups. Group-1 contains 179 patients received intravaginal PGE1 (tablet Misoprostol 25 µg or 50 µg) inserted in the posterior vaginal fornix under all aseptic precautions. Group-2 contains 53 patients who were induced with extra amniotic saline infusion (EASI). The main outcome variables were the number of subjects with favourable Bishop's score, mode of delivery, maternal complications and neonatal outcomes.

Results:  Majority of the patients in both groups were under the age of 21-30 years. There was significant difference in age, parity and gestation age of both groups. In our study we found only 2 cases of postpartum haemorrhage among the entire sample. We also found significant difference in oxytocin augmentation between both groups. The occurrence of hyper stimulation was higher in PGE1 group. We found no significant difference in the occurrence of hyper stimulation and maternal pyrexia among two groups. There was significant difference in the neonatal outcomes of both groups.

Conclusions: PGE1 and EASI have similar efficacy in induction of labour, but in very unfavourable cervices Foley's catheter with EASI is better than other methods of induction especially in areas with limited resources.

Keywords: PGE1, EASI, labour induction, oxytocin, Bishop score.

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Corresponding Author

Rachel Alexander

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