The use of NovaSure under local anaesthesia (LA) has been described as part of efficacy trials, but its use in an outpatient setting has not previously been explored. This prospective study was conducted to determine feasibility and efficacy of NovaSure in the outpatient setting under LA. The study included all women with menorrhagia unresponsive to medical management and were agreeable for treatment under LA (n = 50). The mean duration of procedure was 100 s. A total of 47 (94%) patients were discharged home the same day. Simple analgesics controlled postoperative pain in 44 (88%) patients. Seven (14%) patients gave preference for general anaesthesia for future treatment. The mean pain scores at 30, 60 and 90 min were 4.18, 4.38 and 3.85, respectively on the visual analogue scale. At follow-up, the improvement in menstrual symptoms was seen in 47 (94%) and the satisfaction rate was 43 (86%) and 47 (94%) at 4 and 6 months, respectively.
A randomised controlled trial was conducted to compare the clinical efficacy and cost-effectiveness of Dinoprostone Slow Release Pessary (Propess) with Gel (Prostin) for induction of labour (IOL) at term. A total of 120 women requiring IOL at term with no previous uterine surgery and no contraindication to prostaglandins were included. The main outcome measures were efficacy of drug preparations, patient satisfaction and the cost-effectiveness. The secondary outcome measures noted were maternal complications during the labour, type of delivery, the neonate's Apgar scores at birth and 5 min and incidence of significant morbidities. There were insignificant differences between the two groups in induction-to-delivery interval, mode of delivery, number of women delivering within 24 h and neonatal outcomes. However, the number of vaginal examinations was significantly lower in the Propess group. Propess was found to be more cost effective compared with Prostin in view of single dose and less midwifery hours.
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