A successful induction of labour includes adequate uterine contraction after the addition of the inducing agent, and progressive dilatation of the cervix, thereby resulting in the successful vaginal delivery. Misoprostol has been found to be more superior than other conventional methods and resulting in shorter induction to delivery time. 100 patients with 36 or more gestation period, requiring induction, were divided into 2 groups of 50 each. Group I were given 25 µg misoprostol orally and Group II were given vaginally. Dosage was repeated every 4 hourly and monitored. The major indications of labour were severe pre- eclampsia, post dated pregnancy, mild pre-eclampsia, and PROM. Majority of the women who had undergone induction of labour were primigravida. 90% of patients in the vaginal group delivered vaginally as compared to 80% of the patients in the oral group. Caesarian section was planned in the cases of fetal distress, failure to progress or failed induction of labour. : Women who received vaginal misoprostol experiences shorter induction delivery times, required fewer doses of misoprostol amd required oxytocin augmentation less frequently than those who received oral misoprostol.
High risk pregnancies are these that result in maternal or fetal morbidity or mortality. These may include conditions such as pre-eclampsia, eclampsia, oligohydramnios, anemia. Therefore, it becomes very important for early identification of the risk so that immediate treatment can be given. In order to reduce the morbidity and mortality of both the mother and child. the non stress test and NST with the amniotic fluid volume (Modified biophysical profile) are some of the tests used for this purpose. : After the demographic details and clinical evaluation, Non stress test (NST) was done for all the patients. The fetal heart rate, movements and tone was measured along with the uterine contractions. If there were more than 2 fetal movements with two accelerations of 15 beats / minute or more within 10 mintues of monitoring, the test was rendered reactive. The amniotic fluid volume and Index were measured. The mean age of the women was 23.3 ± 5.1 years and the mean gestational age of them was 34.87 ± 3.91 weeks. The most predominant risk factors which was present in the expectant mothers was decreased movements of the fetus, followed by hypertension and Oligohydramnios. 27% of the patients had to be induced for vaginal delivery while spontaneous delivery was seen in 22% of the cases. 24% of the patients elected to go in for LSCS delivery while emergency LSCS was done on 14% of the patients. 68 (46.9%)mothers with high risk pregnancy had a normal NST and AFI, while 43 (29.7%) of them had an Abnormal NST with Abnormal AFI. 11 (7.6%) of them had Normal NST but an Abnormal AFI and 23 (15.9%) had and Abnormal NST with a Normal AFI. The overall sensitivity and the specificity of NST, AFI and MBPP are comparable to each other in the detection of fetal distress, though MBPP is marginally better.
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