Oxytocin versus sustained-release dinoprostone vaginal pessary for labor induction of unfavorable cervix with Bishop score >= 4 and >= 6: A randomized controlled trial

Aim To compare the efficacy and safety of high-dose intravenous oxytocin and sustained-release dinoprostone vaginal pessaries for cervical ripening and labor induction in pregnant patients at term with poor Bishop scores. Material and Methods Women at term with a Bishop score 4 and 6 were randomized into two groups to undergo induction of labor with either high-dose oxytocin administered intravenously (n=90) or dinoprostone-only vaginal pessary without oxytocin augmentation (n=90). The main outcome measures were rate of cesarean delivery, induction to delivery interval, number of deliveries achieved within 4, 8, 12, and 16h of labor induction, maternal complications during induction, fetal outcome, and total hospital stay. In this study, per-protocol analysis was performed. Results There were fewer cesarean deliveries with oxytocin compared to dinoprostone-only groups (7/79 vs 14/89); however, the difference was not statistically significant. The inductiondelivery intervals (7.9h vs 12.0h, P<0.001; and 5.7 vs 10.4h, P<0.001; oxytocin vs dinoprostone-only for primiparous and multiparous patients, respectively) were significantly shorter in oxytocin-induced patients compared to dinoprostone-only. A significantly higher percentage of patients delivered in the oxytocin group compared to the dinoprostone-only group in 4, 8, 12, 16, and 20h. Conclusion Intravenous oxytocin is effective to stimulate labor at term for patients with Bishop scores 4 and 6, with a shorter time interval from induction to vaginal delivery

The effect of serum and follicular fluid anti-Mullerian hormone level on the number of oocytes retrieved and rate of fertilization and clinical pregnancy

WOS: 000408979800002PubMed: 28058394OBJECTIVE: The objective of this study was to evaluate the relationship between oocyte yield, fertilization, and clinical pregnancy (CP), and anti-Mullerian hormone (AMH) level in serum and follicular fluid during in vitro fertilization treatment. METHODS: Forty-four infertile women who underwent IVF treatment using multiagonist protocol were included in this study. Baseline level of AMH in serum and follicular fluid was measured on third day of menstrual cycle. AMH level in serum and follicular fluid was then measured again on day of oocyte pick-up. Pearson correlation and binary regression tests were used for statistical analysis. For Type 1 error, p= 5% was selected as cut-off value for statistical significance. RESULTS: Serum AMH level was positively correlated with total number of oocytes retrieved and rate of fertilization and CP (r= 0.397, p= 0.008; r= 0.401, p= 0.007; and r= 0.382, p= 0.011, respectively). There was significantly negative correlation between serum level of follicle-stimulating hormone (FSH) and fertilization rate (r=-0.320; p= 0.034), as well as serum FSH level and CP rate (r=-0.308; p= 0.042). There were no significant correlations between AMH level in follicular fluid and IVF treatment outcomes. CONCLUSION: Serum AMH levels may be more reliable for prediction of total number of oocytes retrieved and rate of fertilization and CP than AMH levels in follicular fluid

The effect of gestational hypertension on the maternal mean platelet volume

To evaluate the effect of gestational hypertension on the maternal mean platelet volume (MPV). The study group comprised pregnant women with gestational hypertension who gave birth to single, term, healthy fetuses and control group was pregnant women without any complications. MPVs were calculated within 24 hours in the intrapartum period. The mean MPV of 68 hypertensive and randomly selected 135 normotensive pregnant women were compared. The MPV of gestational hypertensive group was significantly higher (9.5±0.98 vs 9.2±0.9 fL; p=0.015). Using ROC analysis, the optimal MPV cut off value was found 9.25 fL with the sensitivity of 60.0% and the specificity of 61.0% (AUC=0.622, 95% CI=0.538-0.707, p=0.004) for the prediction of gestational hypertension. This study demonstrated that maternal MPV cannot be used to predict gestational hypertension in clinical practice due to its low sensitivity and specificity. However, further studies are needed to examine the predictive value of MPV in the progression of the hypertensive diseases of pregnancy. [Med-Science 2020; 9(1.000): 90-3