A comparative study between PGE1 and PGE2 for induction of labour in premature rupture of membrane at term

Background: Premature rupture of membranes at term can be managed expectantly with good results. However, low bishop score may lead to undue latency. It can lead to complications if no intervention done. So, timely intervention by labour induction in selected cases can improve maternal and fetal outcome. Prostaglandins has very vital role for induction of labour. This study is to compare the effectiveness between the two molecules of prostaglandins PGE1 and PGE2 for induction of labour in term premature rupture of membrane (PROM).Methods: It is a prospective interventional study performed at a tertiary hospital attached to a medical college. It was conducted upon randomly selected 100 women of term PROM from April 2011 to April 2015. They were divided into two comparable groups each containing 50 women. Both the groups were comparable in age, parity and bishop score. One group was induced with PGE1 (Tab Misoprostol) and the other with PGE2 (Dinoprostone gel).Results: Among 100 women, a good number of women were primigravida (76%). Majority of women were induced in between 6 to 12 hours after PROM (69%). Vaginal deliveries were 68% in tab. Misoprostol group while 80% in dinoprostone gel group which are comparable in both the groups. The significant difference observed was average induction delivery interval, which was 11.26 hours in tab. misoprostol group and 14.72 hours in dinoprostone gel group (P=0.004). The other women (26%) underwent cesarean section. Among them 46.15% were done for fetal distress and 43.84% for induction failure.Conclusions: Both the molecules of prostaglandins are efficient for labour induction in term PROM.  Though, PGE1 (tab. Misoprostol) is faster acting as compare to PGE2 (dinoprostone gel) even with low bishop score. But it can lead to complications like hyperstimulation, fetal distress and postpartum hemorrhage if not used properly. So, tab misoprostol is not a safe drug where continuous monitoring of women is not available

Self-medication of abortion pills and its complications: an observational study

Background: Medical termination of pregnancy has been legalized in India since 1971. Medical abortion pill is well effective in early weeks of pregnancy. It is safe only when it is used under medical supervision. This study was carried out to analyse the complications following self-medication of abortion pills and to suggest measures to prevent such practice.Methods: This was a retrospective observational study conducted at our hospital from March 2017 to July 2017.Results: In present study 30 (75%) patients were in age group of 20-30 years. Illiterate patients were 22 (55%). Half of the patients, 20 (50%) were having three or more than three children. Majority of women 30 (75%) had consumed the abortion pills 1-10 days before coming to the hospital and 14 (35%) of patients had come with complain of excessive bleeding per vagina. Incomplete abortion was present in 32 (80%) of patients. Instrumental evacuation was required in 28 (87.5%) patients. Laparotomy for ruptured ectopic and rupture uterus was performed in 1 (2.5%) of each patient. 6 (15%) patients were severely anaemic. Transfusion of blood was required in 9 (22.5%) of patients.Conclusions: Medical abortion is effective and safe when carried out under medical supervision. Unsupervised use of medical abortion pills was associated with many complications like incomplete abortion, rupture ectopic and ruptured uterus. So, over the counter sale of medical abortion pill should be restricted

Study of feto-maternal outcome in patients of jaundice in third trimester of pregnancy

Background: Jaundice in pregnancy is an important medical disorder, more commonly seen in developing countries than developed ones. It comprises of a formidable list of complications that may adversely affect the pregnant woman and her fetus. Objective of current study was to study causes and feto-maternal outcome in pregnancies with jaundice in 3rd trimester.Methods: This was a retrospective study of 49 patients admitted in department of Obstetrics & Gynaecology at a tertiary care hospital with jaundice in 3rd trimester of pregnancy during the period from September 2008 to September 2010.Results: Out of 9972 deliveries, 49 patients were admitted with jaundice in 3rd trimester of pregnancy. Out of them 91.1% patients delivered. Vaginal delivery occurred in 82.2% and Cesarean section done in 17.7%. Preterm delivery occurred in 68.8%, low birth weight (LBW) was found in 82.2%, perinatal mortality occurred in 34.6% and maternal mortality occurred in 16.3% of patients.Conclusions: Jaundice in 3rd trimester of pregnancy leads to preterm delivery, fetal distress, intra uterine fetal death (IUFD) and high perinatal & maternal morbidity and mortality. Early diagnosis & aggressive management at tertiary care center help in reducing maternal & perinatal morbiditiy and mortality

A comparative study between PGE1 and PGE2 for induction of labour in premature rupture of membrane at term

Background: Premature rupture of membranes at term can be managed expectantly with good results. However, low bishop score may lead to undue latency. It can lead to complications if no intervention done. So, timely intervention by labour induction in selected cases can improve maternal and fetal outcome. Prostaglandins has very vital role for induction of labour. This study is to compare the effectiveness between the two molecules of prostaglandins PGE1 and PGE2 for induction of labour in term premature rupture of membrane (PROM).Methods: It is a prospective interventional study performed at a tertiary hospital attached to a medical college. It was conducted upon randomly selected 100 women of term PROM from April 2011 to April 2015. They were divided into two comparable groups each containing 50 women. Both the groups were comparable in age, parity and bishop score. One group was induced with PGE1 (Tab Misoprostol) and the other with PGE2 (Dinoprostone gel).Results: Among 100 women, a good number of women were primigravida (76%). Majority of women were induced in between 6 to 12 hours after PROM (69%). Vaginal deliveries were 68% in tab. Misoprostol group while 80% in dinoprostone gel group which are comparable in both the groups. The significant difference observed was average induction delivery interval, which was 11.26 hours in tab. misoprostol group and 14.72 hours in dinoprostone gel group (P=0.004). The other women (26%) underwent cesarean section. Among them 46.15% were done for fetal distress and 43.84% for induction failure.Conclusions: Both the molecules of prostaglandins are efficient for labour induction in term PROM.  Though, PGE1 (tab. Misoprostol) is faster acting as compare to PGE2 (dinoprostone gel) even with low bishop score. But it can lead to complications like hyperstimulation, fetal distress and postpartum hemorrhage if not used properly. So, tab misoprostol is not a safe drug where continuous monitoring of women is not available

Self-medication of abortion pills and its complications: an observational study

Background: Medical termination of pregnancy has been legalized in India since 1971. Medical abortion pill is well effective in early weeks of pregnancy. It is safe only when it is used under medical supervision. This study was carried out to analyse the complications following self-medication of abortion pills and to suggest measures to prevent such practice.Methods: This was a retrospective observational study conducted at our hospital from March 2017 to July 2017.Results: In present study 30 (75%) patients were in age group of 20-30 years. Illiterate patients were 22 (55%). Half of the patients, 20 (50%) were having three or more than three children. Majority of women 30 (75%) had consumed the abortion pills 1-10 days before coming to the hospital and 14 (35%) of patients had come with complain of excessive bleeding per vagina. Incomplete abortion was present in 32 (80%) of patients. Instrumental evacuation was required in 28 (87.5%) patients. Laparotomy for ruptured ectopic and rupture uterus was performed in 1 (2.5%) of each patient. 6 (15%) patients were severely anaemic. Transfusion of blood was required in 9 (22.5%) of patients.Conclusions: Medical abortion is effective and safe when carried out under medical supervision. Unsupervised use of medical abortion pills was associated with many complications like incomplete abortion, rupture ectopic and ruptured uterus. So, over the counter sale of medical abortion pill should be restricted