Comparing the effects of vaginal misoprostol, laminaria, and extra amniotic saline infusion on cervical ripening and induction of labor

Abstract

Objective This study aimed to compare the effects of vaginal misoprostol, laminaria, and extra-amniotic saline infusion (EASI) on cervical ripening. Methods This randomized controlled trial was conducted on 195 women with singleton pregnancies and unripe cervices. Participants were randomly allocated to 3, 65-person groups: a misoprostol, a laminaria, and an EASI group. The interventions in the misoprostol, laminaria, and EASI groups included a single 25-µg vaginal misoprostol suppository, an intracervical laminaria, and a transcervical Foley catheter, respectively. The groups were compared with each other regarding time intervals from labor induction to labor active phase and delivery, cervical dilation, Bishop scores 6 hours after induction, delivery type, length of hospital stay, and complications. Results There were no significant differences among the groups regarding maternal ages, gestational ages, body mass indices, baseline cervical dilations, and Bishop scores (P>0.05). Six hours after induction, the Bishop score and cervical dilation were significantly greater in the EASI group than in the other 2 groups (P<0.001). Moreover, time intervals from labor induction to labor active phase and delivery in the EASI group were significantly short (P<0.001). The rates of cesarean section, fetal distress, placental abruption, and meconium staining in the misoprostol group were significantly high (P<0.05), and the length of hospital stay in the EASI group was significantly short (P<0.001). Conclusion EASI is a safer and more effective method for cervical ripening. Considering its inexpensiveness, easy accessibility, and greater effectiveness, EASI is recommended for cervical ripening.

Intra Cervical Foley’s Versus Combination Of Intra Cervical Foley’s And Extra Amniotic Saline Infusion As Cervical Ripening Agent For Induction Of Labor

“…Dhakal et al also compared ICF and EASI for IOL and showed similar results in which 44 out of 50 patients in the ICF group and 42 out of 50 patients in the ICF and EASI group underwent successful labour. 28 The findings are comparable to our study where 42 /50 in group A and 44/50 in group B were delivered vaginally. Studies have also compared EASI with Prostaglandins and reported that 37% of women in EASI group achieved a Bishop Score of ≥ 8 at 8 hours as compared to 14% who received Prostaglandins .…”

“…In many studies reported in the literature, all of the patients' babies were alive and healthy and none required NICU admission. 27,28,33,40,41 In contrast, in our study, a total of 8 patients required NICU admissions. The difference might be due to the setting of a public sector hospital in a developing country where due to lack of resources, increased burden on the doctors and staff, illiteracy, poverty, along poor sanitary conditions predispose the neonates to various infections and risk factors that lead to NICU admission.…”

“…Other studies also showed similar statistics in which more than 50% of the patients eligible for IOL were primigravida. 21,27,28 Reason is that most of the multigravida went into spontaneous labour because of previous vaginal deliveries as compared to primigravidas. 28,29,30,31 Although the mean gestational age of all the patients was 39.31 ± 1.16 weeks the major reason for IOL in our study was post-dates.i.e., 42% which is comparable to another study which showed that the majority of patients were 40 to 41 weeks.32.…”

Comparison of Efficacy of Pervaginal Misoprostol, Intracervical Foley Catheter, Intracervical Dinoprostone on Induction of Labor

“…24,25 Hence, Foley catheter is a good method of induction of labor which is effective, safe, economical, easy to store, readily available, with less side effects. 26,27…”

Comparing the effects of vaginal and oral evening primrose oil on cervical ripening and labor progress among primiparous women

“…According to the studies along with their positive effects, medicationbased therapies for CR also have adverse effects. These complications include perinatal and postnatal bleeding, prolonged labor, excessive stimulation of the uterus, fetal distress and injuries, nausea, vomiting, and fever (2,(12)(13)(14). Continuous professional training, especially in medicine, is changing and developing (15).…”