Dhivya, M (2020) Comparison of Mifepristone with Foley's Catheter for Induction of Labour in Post Dated Pregnancy. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
BACKGROUND: Induction of labor is artificial initiation of uterine contractions before spontaneous onset of labor or after the period of viability of the fetus. Induction of labour is indicated when complications of pregnancy may have a negative impact on the health of the mother, fetus, or both. Induction of labour is therapeutic option when the benefits of the delivery outweigh the risks of continuing the pregnancy. Routine antenatal ultrasound for confirmation of EDD has been shown to reduce induction rates for post dated pregnancies after correction of dates. Prolonged pregnancy is known to be associated with significantly increased risks of perinatal and maternal complications. Induction of labour is planned for many indications. In this study induction of labour done for post dated pregnancies was taken into account. The purpose of this study is to compare the efficacy of mifepristone with foley’s catheter for induction of labour in post dated pregnancies. The drug have been chosen for the above study based on cost factor, safety profile and the results shown by previous studies. This will be of very use in future management of post dated pregnant woman planned for induction of labor. AIMS OF THE STUDY: To compare the safety and efficacy of mifepristone and foley’s catheter for induction of labour in post dated pregnancies METHODOLOGY: This is a randomized comparative study conducted from Jan 2018 to Dec 2018 in Department of Obstetrics and Gynaecology, Coimbatore Medical College Hospital. Two hundred post dated pregnant mothers were enrolled in the study based on inclusion and exclusion criteria. All patients were explained about the study and informed written consent was obtained from them in the language of their convenience. A thorough history regarding the regularity of menstrual cycle, LMP, dating scan, risk factors of post dated pregnancy, past obstetric history were obtained and recorded. Complete systemic and obstetric examination were done in all patients.Complete blood count,blood sugar, renal function test, ultrasound obstetrics were done in all patients. Per vaginal examination done to assess adequacy of pelvis, the bishop’s score of the patients included in the study. The results obtained by considering the following parameters, Changes in the bishop’s score, Induction delivery interval, Mode of delivery, Neonatal outcome, Incidence of PPH. Patients were randomised into two groups. One group were treated with Tab. Mifepristone and another group were treated with Foley’s catheter. After 24 hours, the treatment results were noted by change in the Bishop's score, need for further induction with prostaglandins or augmentation with ARM or oxytocin, fetal heart rate monitoring to rule out fetal distress, mode of delivery, induction delivery interval, incidence of PPH. Thus the efficacy of Mifepristone with Foley’s catheter for induction of labor in post dated pregnancies were studied and compared. RESULTS: Our study included 200 patients out of which 100 were treated with Mifepristone, 100 were treated with Foley’s catheter. Among the study group, 135 women are Primigravida and 65 women are multigravida. The mean age for the women in the study group were in between 24 -25 yrs. The mode of delivery in the women who were enrolled in the study was found to be significant as 84% of patient in mifepristone group delivered vaginally compared to 64% in foley’s induction group.16% patients were undergone caesarean section in mifepristone group as compared to 33% in the foley’s induction group. The mean duration of induction –delivery interval was found to be 26 hours in mifepristone group compared to 36 hours in foley’s group.The incidence of respiratory distress in mifepristone group was found to be 3% compared to 12% in foley’s group. The incidence of PPH observed in the study was found to be insignificant. CONCLUSION: Thus, based on the results observed in our study, Tab.Mifepristone can be considered as effective in induction of labour in post dated pregnancy.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221716303 |
| Uncontrolled Keywords: | Induction of labor, Postdated, pregnancy, Mifepristone, Foley's catheter, induction-delivery interval, neonatal outcome. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Feb 2021 17:18 |
| Last Modified: | 16 Feb 2021 17:18 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14278 |
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