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Indian Journal of Obstetrics and Gynecology

Volume  8, Issue 3, July–September 2020, Pages 174-180
 

Original Article

Analysis of Prostaglandins (Pge1 and Pge2) in Induction of Labour

Kunal Manikrao Jadhav1, Shubhangi Mande2, Vikram S Lokhande3, Sneha Kusum

1,2Assistant professor, 3Senior Resident, 4Professor, Department of Obstetrics and Gynecology, MGM Medical College, N-6, CIDC, Aurangabad, Maharashtra 431002, India.

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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.8320.11

Abstract

Introduction: According to the definition by World Health Organization normal labour as“spontaneous in onset, low risk at the start of labour
and remaining so throughout labour and delivery.Induction of labour is the non spontaneous initiationof uterine contractions that result in progressive cervical effacement and dilatation with descent of the presenting part to achieve vaginal delivery. Themethod of administration that has been explored thoroughly is PGE2 i.e, cerviprime gel. Though this is widely used, it is expensive and requires refrigeration
for storage. The second method of administrationused is Misoprostol or PGE1 tablets which is comparably cheap, safe and cost effective.


Aim and Objective: In the present study, our traditional methods of cervical ripening with endocervical prostaglandin E2 gel, and intravaginal prostaglandins PGE1 was used, to know the outcome
after using these two drugs. Material and Methods: The present Prospective Observational study was conducted in a Tertiary Care hospital during October 2015 to October 2017 amongst 100 patients admitted in labor room with following indication, Induction of labor in women at or beyond term, Induction of labor in women with pre-labor rupture of membranes, IUGR with or without Oligohydrominos, I.U.F.D and Hypertensive disorder of pregnancy. For induction, Misoprostol
was used in 26 patients and Dinoprostone (cerviprime) was used in 74 patients. Obstetrician were free to use their choice of drugs, between two, we have observed that Dinoprostone was more commonly used.


Result: Percentage of induction was more in Primigravida, but parity wise it was comparable. Dinoprostone used slightly more in Primigravida. It was found that irrespective of bishop scorevaginal delivery was found to be more. Overall vaginal delivery with misoprostol group was more. It is statistically significant. The time required for
delivery with misoprostol is less as compared with Dinoprostone which is statistically significant. It was found that induction done with Tab. Misoprostol has the highest vaginal delivery rate with 1 or 2 doses, and in Dinoprostone maximum 3 doses were required. 11.3% required LSCS for foetal distress and around 17% of patients landed up in failure of induction. None of the misoprostol group had failure of Induction. No any complications were found like hypertonous, tachysystole, and rupture of uterus.


Conclusion: From the present study it was concluded that PGE2 (Dinoprostone) and PGE1(Misoprostol) are equally safe, Obstetrician was freeto use their choice of drugs, and we have observed
that Dinoprostone was commonly used. Considering its safety it is observed that both are equally safe, but the cost effectiveness of misoprostol is more, whichmay be the drug of choice in coming years.

Introduction: According to the definition byWorld Health Organization normal labour as“spontaneous in onset, low risk at the start of labour
and remaining so throughout labour and delivery.Induction of labour is the non spontaneous initiationof uterine contractions that result in progressiv ecervical effacement and dilatation with descent of
the presenting part to achieve vaginal delivery. Themethod of administration that has been exploredthoroughly is PGE2 i.e, cerviprime gel. Though this iswidely used, it is expensive and requires refrigeration
for storage. The second method of administration used is Misoprostol or PGE1 tablets which is comparably cheap, safe and cost effective.


Aim and Objective: In the present study, our traditional methods of cervical ripening with endocervical prostaglandin E2 gel, and intravaginal prostaglandins PGE1 was used, to know the outcome
after using these two drugs.


Material and Methods: The present Prospective Observational study was conducted in a Tertiary Care hospital during October 2015 to October 2017amongst 100 patients admitted in labor room with
following indication, Induction of labor in women at or beyond term, Induction of labor in women with pre-labor rupture of membranes, IUGR with orwithout Oligohydrominos, I.U.F.D and Hypertensivedisorder of pregnancy. For induction, Misoprostol was used in 26 patients and Dinoprostone (cerviprime) was used in 74 patients. Obstetrician were free to use their choice of drugs, between two, we have observed
that Dinoprostone was more commonly used.


Result: Percentage of induction was more in Primigravida, but parity wise it was comparable.Dinoprostone used slightly more in Primigravida.
It was found that irrespective of bishop scorevaginal delivery was found to be more. Overallvaginal delivery with misoprostol group was more.
It is statistically significant. The time required fordelivery with misoprostol is less as compared with Dinoprostone which is statistically significant. It was found that induction done with Tab. Misoprostolhas the highest vaginal delivery rate with 1 or 2 doses, and in Dinoprostone maximum 3 doses wererequired. 11.3% required LSCS for foetal distress
and around 17% of patients landed up in failure of induction. None of the misoprostol group had failure of Induction. No any complications were found like hypertonous, tachysystole, and rupture of uterus.

Conclusion: From the present study it wasconcluded that PGE2 (Dinoprostone) and PGE1 (Misoprostol) are equally safe, Obstetrician was free to use their choice of drugs, and we have observed
that Dinoprostone was commonly used. Considering its safety it is observed that both are equally safe, but the cost effectiveness of misoprostol is more, which may be the drug of choice in coming years.


Keywords : Prostaglandins; Misoprostol; Dinoprostone; Cerviprime; Induction. Prostaglandins; Misoprostol; Dinoprostone; Cerviprime; Induction.
Corresponding Author : Vikram S Lokhande.