Background: Labor is defined as a cascade of effective uterine contractions leading to progressive effacement and dilatation of cervix resulting in the expulsion of the fetus, placenta and the membranes. The aim of the study was to evaluate the effect of single time and double time application of dinoprostone E2 gel and to compare fetomaternal outcomes after single and double application of dinoprostone E2 gel and its complications.Methods: This was a prospective observational study conducted on 200 pregnant females with a period of gestation ≥37 completed weeks between 1st January 2020 to 31st January 2021. Group A included females undergoing single time application of PGE2 gel and in group B, second dose applied after 6 hrs of first dose if there was no improvement in Bishop score. If necessary, oxytocin for augmentation of labor was started only 6 hrs after the last dose.Results: Mean age in group A was 24.38±4.37 years and in group B was 24.02±3.76 years and this difference was not found statistically significant (p>0.05). Majority of cases had vaginal delivery. In group A, 28% cases had LSCS delivery while in group B, 17% cases had LSCS delivery (p>0.05). There was significant increase in mean Bishop score after second dose of PGE2 gel in double application group by 3.24 assessed at 12 hours after induction. Double times application of gel resulted in a smaller number of failed inductions i.e.; 23 out of 100 cases in single application group and 7 out of 100 cases in double application group. Main maternal complication was nausea and vomiting which was 5% cases in group A and 11% cases in group B.Conclusions: Double times application of dinoprostone gel resulted in improved Bishop score, facilitates the process of induction, increased number of successful inductions, shortened application delivery interval and decreased cesarean section rate compared to single application. There was slight increase in maternal and fetal complications with double times application.
A study of of endometrial thickness on TVS in relation with histopathology report on dilation and curettage. AIM AND OBJECTIVE-To set a cut off limit of endometrial thickness on TVS for differtiating between normal and abnormal endometrium. MATERIAL AND METHOD-hospital based comparative study. RESULTS-TVS is non invasive ,simple first line procedure in AUB women. Mean endometrial thickness in normal endometrial group was 8.00±2.44 mm and in abnormal endometrial group was 15.16±33 mm.The difference was found highly significant (p value<.001)
Background: Induction of labor means initiation of uterine contraction, after period of viability by any method (medical, surgical or combined) before spontaneous onset of labor for the purpose of vaginal delivery. The condition of cervix or favorability is important for successful labor induction. Assessment of cervix has been used as a predictor of successful vaginal delivery. Induction of labor carried out in approximately 20% of all pregnancies. Aim and objectives of the current study were to compare the predictive value of trans-vaginal ultra-sonographic measurement of cervical length versus Bishop score prior to induction of labor in predicting the mode of delivery and maternal and fetal outcome.Methods: This prospective observational study was conducted in the department of obstetrics and gynecology, Sardar Patel medical college and associated group of hospitals, Bikaner between February to November 2020. Study group included 100 pregnant women in which induction of labor was performed at 37-42 weeks of gestation.Results: Bishop Score appears to be a better predictor than the cervical length with sensitivity of 1.00 and a specificity of 0.12 compared to 0.52 and 1.00 respectively. In the receiver operating characteristic curves, the cut-off point for the prediction of successful induction taken was 2.6 cm cervical length and >4 for the bishop score.Conclusions: TVS cervical length could be used as alternative to Bishop score for prediction of successful labor induction in the sitting where the appropriate equipment and expertise are available. Bishop score and TVS cervical length both are good predictors of successful induction of labor.
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