Abstract :
Introduction: In order for induction to be successful, it should result in labour with adequate uterine contraction and progressive dilatation of cervix with the outcome of a vaginal delivery with minimal risk to both mother and foetus. Primary outcome of the current study was to compare various modalities of Induction of Labour, alone or in combination & to evaluate the different outcomes of mother and baby.
Materials and Methods: History, general, obstetrical, vaginal examination to record Modified Bishop score, basic investigations and recent obstetric ultrasound was noted of 200 pregnant mothers and the results were analyzed. Foetal monitoring was done in all except those with confirmed IUFD cases. Methods used were Dinoprostone, Misoprostol, Oxytocin, Amniotomy and Mechanical Dilatation with Foley’s catheter; single or in combination with each other.
Results: Among the 200 mothers, 118(59%) delivered vaginally and 82 (41%) mothers underwent LSCS. Dinoprostone gel was the dominant method used followed by misoprostol and oxytocin respectively. NICU admissions were required in 21.7%, 25,8% & 33.3% of the mothers who were induced with Dinoprostone, Misoprostol and Oxytocin respectively. 14 babies were diagnosed with IUFD, all delivered vaginally, out of which 10 were induced with misoprostol and 4 were induced with mechanical dilatation. Majority of the patients who underwent induction with dinoprostone alone delivered by LSCS (63.4%) but Dinoprostone with ARM & oxytocin for induction had a better outcome. Induction with Dinoprostone followed by misoprostol lead to more LSCS than SVD and there were 1%(2 babies) of perinatal mortality due to Meconium Aspiration Syndrome.
Conclusion: Misoprostol and Mechanical induction were the most preferred method in cases of IUFD. Induction with a combination of Dinoprostone with ARM or Oxytocin lead to more vaginal delivery than Dinoprostone alone, so this should be preferred. Induction with Dinoprostone followed by misoprostol lead to more LSCS and perinatal mortality so a combination of them should be given cautiously.
Keyword :
Dinoprostone, Misoprostol, Induction of labour, Oxytocin, Amniotomy, Mechanical dilatation.