الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Objectives: Our purpose was to compare orally administered with vaginally administered misoprostol for cervical ripening and labor induction.
Patients and Methods: 40 subjects with medical or obstetrical indications for labor induction and undilated,
uneffaced cervices were randomly assigned to receive orally
administered or vaginally administered misoprostol. 50ug of oral misoprostol or 25ug of vaginal misoprostol was given every 4 hrs. If cervical ripening( Bishop score of ≥ 8 or cervical
dilatation of ≥ 3cm) or active labor didn’t occur, repeated doses were given to a maximum of 6 doses or 24 hrs.Thereafte, oxytocin was administered intravenously by a standardized incremental infusion protocol to a maximum of 22mU/min.
Results: of the 40 subjects evaluated, 20 received orally administered misoprostol and 20 subjects received vaginally administered misoprostol. fewer orally treated subjects(3 cases
where 2 cases are multigravida and 1 case primigravida) were delivered in 24 hrs of the initiation of induction, in comparison with the vaginally treated group(16 cases where 9 cases are
multigravida and 7 cases are primigravida). The time from induction to delivery in the orally treated group was 35.5±12 hrs(mean and SD)in nulligravida, 23±13 hrs (mean and SD) in
multigravida, while in the vaginally treated group was 21.5±14 hrs(mean and SD)in nulligravida,19±10 hrs(mean and SD)in multigravida. the mean time interval between the induction to
initiation of vaginal delivery between the orally treated group 28.9±13 hrs(mean and SD) while in the vaginally treated group 20±13 hrs(mean and SD). the induction to initiation of delivery
(vaginal or abdominal) as 29±12 hrs(mean and SD) in the orally treated group, 21±12 hrs(mean and SD) in the vaginally treated group. the average number of doses of misoprostol used for
induction as 3.3±1.7(mean and SD) in the orally treated group while 2.2±1.3(mean and SD) in the vaginally treated group (P = 0.043). Oxytocin augmentation was used in 15 cases in the
orally treated and 12 cases in the vaginally treated group(P = 0.500).
The number of cases delivered vaginally in the orally treated group 12 cases(60%) while in the vaginally treated group 19 cases(95%). The number of cases delivered by CS in the orally treated group were 8 cases while in the vaginally treated group were 1 case( P = 0.023). Chorioamnionitis occurred in 4
cases in oral group, 3 cases in the vaginal group. Uterine tachysystol occurred in 1 case in oral group, 2 cases in the vaginal group. Uterine hypertonus occurred in 1 case in the oral group while no cases reported in the vaginal group. Abnormal
FHR pattern reported in 5 cases in the oral group,6 cases in the vaginal group with no statistical difference between both groups. The neonatal outcome show no statistical difference between both groups.
Conclusion: Oral administration of 50ug of misoprostol appears less effective than vaginal administration of 25ug of
misoprostol for cervical ripening and labor induction.