A randomised controlled clinical trial was performed on 180 pregnant women with indications for labour induction who were divided into 2 groups. Groups 1: each pregnant woman received 50 μg intravaginal misoprostol every 4h (total 250 μg). Group 2: intravenous oxyticin to induce the labour. The successful rate of misoprotol group was 89,89%, higher than oxytocin group- 70%. The interval from induction to vaginal delivery was longer in misoprostol group (8,47± 2,85h verus 6,45± 2,64h)
Labor, Induced ; misoprostol ; Oxytocin ;

No abstract available.
Female ; Labor, Induced* ; Pregnancy*

Background: A prolonged interval from prelabor rupture of membranes to delivery is associated with an increase in the incidence of maternal and neonatal morbidities and mortality. Various agents have been tested to improve the cervical Bishop score to expedite the delivery of the fetus and lessen the maternal and neonatal complications. Objective: To compare two protocols for labor induction in pregnant women with prelabor rupture of membranes (PROM). Population: Subjects were recruited from the University of Santo Tomas Hospital (Private Division and Clinical Division). Pregnant women with a live, term, singleton fetus, cephalic presentation, a reactive Non stress test, who presented with PROM and a Bishop score of ?5, with no previous Cesarean section, or other uterine surgery. Methodology: This is a two-arm superiority, open label, randomized controlled trial. Pregnant women with a live, term, singleton fetus, cephalic presentation, a reactive Non stress test, who presented with PROM and a Bishop score of ?5, and with no previous Cesarean section or other uterine surgery were randomly assigned to receive either intravenous (IV) oxytocin infusion or intracervical dinoprostone 0.5 mg gel followed 6 hours later by IV oxytocin infusion. Results: Vaginal delivery within 24 hours of labor induction increased significantly with intracervical dinoprostone gel followed by IV oxytocin infusion (87% versus 61%; RR: 1.43; 95% CI: 0.99 – 2.06; P<0.044). Comparable result was observed for nulliparous women included in the study population. The time interval from labor induction to active phase was significantly shorter in the dinoprostone-oxytocin group than in the oxytocin alone group (2.4 ± 2.1 versus 6.3 ± 1.4 hours; p<0.001). The time interval from labor induction to delivery was also significantly shorter in the dinoprostoneoxytocin group (6.3 ± 1.5 versus 10.4 ± 1.4 hours; p<0.000). Cesarean delivery rates were statistically similar in the dinoprostone-oxytocin and oxytocin alone groups (17% versus 40%; p=0.102). The neonatal outcomes were comparable in both groups, except for birth weight. Conclusion Intracervical dinoprostone 0.5 mg gel followed 6 hours later by an oxytocin infusion in term women presenting with PROM and an unfavorable cervix (Bishop Score of 5 or less) was associated with a higher rate of vaginal delivery within 24 hours, shorter time interval from labor induction to active phase of labor, and shorter time interval from labor induction to delivery, and no difference in maternal and neonatal complications was observed compared with oxytocin infusion alone.
Dinoprostone ; Oxytocin ; Labor ; Induced

OBJECTIVE: Our purpose was to determine the effect of epidural analgesia on the first phase of labor and mode of delivery of nulliparous women. METHODS: We studied 170 nulliparous women at near-term who underwent spontaneous and induced labor at the Department of Obstetrics and Gynecology, Hanyang University Hospital from January 1999 to May 2000 prospectively. Eighty women who were received epidural analgesia for pain relief were compared to ninety women as control group. Cesarean delivery was performed when indicated. RESULTS: The demographic characteristics of the two groups were similar with respect to age, height, weight, gestational weeks, and gravida. The two groups had the same cervical dilatation at the time of analgesia. There were no statistically significant difference between two groups. The length of the first phase of labor was same between two groups(558.4+/-50.4 min. vs 452.1+/-46.7 min.). There were statistically significant differences in the instrument delivery and cesarean section rate between two groups(43 vs. 32, 8 vs. 16 respectively). CONCLUSIONS: Epidural analgesia provides safe and effective intrapartum pain control and may be administered without undesirable effects on the first phase of labor and delivery.
Analgesia ; Analgesia, Epidural* ; Cesarean Section ; Female ; Gynecology ; Humans ; Labor Stage, First ; Labor, Induced ; Obstetrics ; Pregnancy ; Prospective Studies

Using literature research in CNKI, VIP, and CBM from 2002 to 2008, sixty-five papers were retrieved. The results reveals that the research of acupuncture application in inducing labor focused on clinical practices, acupuncture has remarkable effectiveness and its advantages in facilitating contractions, shortening birth process, and elevating labor pain. However, the clinical trials demands large sample of multi-center randomized controlled trials, improved standard evaluation system, consistency in research, and further exploration in basic re search. These areas demand further devetions from acupuncture researchers.
Acupuncture Therapy ; China ; Female ; Humans ; Labor Pain ; therapy ; Labor, Induced ; statistics & numerical data ; Pregnancy ; Randomized Controlled Trials as Topic

OBJECTIVE: After globally acceptance of planned vaginal birth after cesarean section (VBAC), the mode of induction is still a matter of debate and requires further discussion. We aimed to study obstetric outcomes in post-cesarean patients undergoing induction of labor with prostaglandin gel compared with patients who developed spontaneous labor pains. METHODS: All patients at 34 weeks or more of gestation with previous one cesarean section eligible for trial of labor after cesarean section admitted in a labor room within one year were divided in 2 groups. Group one consisted of patients who experienced the spontaneous onset of labor pains and group 2 consisted of patients who underwent induction of labor with prostaglandin gel. They were analyzed for maternofetal outcomes. Descriptive statistics, independent sample t-test, and chi-square test were applied using SPSS 20 software for statistical analysis. RESULTS: Both groups were comparable in maternal age, parity, and fetal weight, but different in bishop score, mode of delivery, and neonatal outcome. Admisson bishop score was 6.61±2.51 in group 1 and 3.15±1.27 in group 2 (P<0.005). In the patients who experienced spontaneous labor, 86.82% had successful VBAC. In the patients with induced labor, 64.34% had successful VBAC with an average dose of gel of 1.65±0.75. Both groups had one case each of uterine rupture. The neonatal intensive care unit admission rate was 4.1% in group one and 10.4% in group 2. CONCLUSION: This study reflects that supervised labor induction with prostaglandin gel in previous one cesarean section patients is a safe and effective option.
Cesarean Section ; Female ; Fetal Weight ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Labor Pain ; Labor, Induced ; Maternal Age ; Parity ; Pregnancy ; Prostaglandins ; Trial of Labor ; Uterine Rupture ; Vaginal Birth after Cesarean

Misoprostol (Cytotec) is a prostaglandin E1 analog used in prevention of nonsteroidal anti-inflammatory drugs induced gastric ulcer and has a uterotonic effect. It has been used to terminate pregnancy at any stage by promoting uterine contractions and for ripening the cervix before induced labor or abortion. Recently, it is known to reduce postpartum hemorrhage. Very little experience has been reported acute misoprostol toxicity in contrast with its usages. We have experienced a case of acute toxicity of misoprostol used for management of postpartum hemorrhage. We report this case with a review of literatures.
Alprostadil ; Cervix Uteri ; Female ; Labor, Induced ; Misoprostol* ; Postpartum Hemorrhage ; Pregnancy ; Stomach Ulcer ; Uterine Contraction

Misoprostol (Cytotec) is a prostaglandin E1 analog used in prevention of nonsteroidal anti-inflammatory drugs induced gastric ulcer and has a uterotonic effect. It has been used to terminate pregnancy at any stage by promoting uterine contractions and for ripening the cervix before induced labor or abortion. Recently, it is known to reduce postpartum hemorrhage. Very little experience has been reported acute misoprostol toxicity in contrast with its usages. We have experienced a case of acute toxicity of misoprostol used for management of postpartum hemorrhage. We report this case with a review of literatures.
Alprostadil ; Cervix Uteri ; Female ; Labor, Induced ; Misoprostol* ; Postpartum Hemorrhage ; Pregnancy ; Stomach Ulcer ; Uterine Contraction

OBJECTIVETo evaluate the efficacy and safety of misoprostol in term labour induction.

DATA SOURCESData from published English and Chinese literatures about misoprostol in term labour induction were identified from Medline and CBMdisk (using the search terms "misoprostol" and "labour induction") before 2001; hand searches of reference lists of original studies and reviews (including meta-analyses) and contact with investigators in this field before 2001.

STUDY SELECTIONStudies were included if they had data on misoprostol and labour induction. Altogether 623 articles were found and 124 were admitted, including 19,287 cases.

DATA EXTRACTIONData were collected on efficacy and incidence of side-effects of misoprostol and oxytocin. Data were checked for consistency within the published articles and converted into a standard format for incorporation into a central database.

DATA SYNTHESISThe average successful induction rate, rates of caesarean section; incidence of tachysystole, hypertonus of uterus and precipitous labour, and rates of meconium stained amniotic fluid between the misoprostol and oxytocin groups were significantly different (P < 0.05). There were no significant differences between the two groups concerning the average interval from the administration of misoprostol and oxytocin to the onset of labour, duration of the total stage of labour, incidence rate of foetal distress, neonatal asphyxia (1-minute Apgar score < and= 7), postpartum haemorrhage or amount of blood loss in postpartum.

CONCLUSIONSMisoprostol is a superior agent over oxytocin on the induction of term labour, but its application might increase the risk of precipitous labour, abnormal uterine contractions or meconium stained amniotic fluid. Therefore, the dosages and regimens of the agent need further investigation.

Female ; Humans ; Labor, Induced ; methods ; Misoprostol ; adverse effects ; Oxytocics ; adverse effects ; Oxytocin ; Pregnancy ; Safety

OBJECTIVE: To determine the efficacy and safety of labor induction in patients previously delivered by a low transverse cesarean section. METHOD: A retrospective review was done at Chonnam National University Hospital, Kwangju, Korea. All patients with a previous cesarean section who required labor induction from April, 1986 to June, 1999 were identified. Outcome of labor induction, including mode of delivery, maternal and perinatal morbidity, and birth trauma were evaluated. RESULTS: Trial of labor was undertaken by 1256 women(55.8%) who had previously been delivered by a low transverse cesarean section. 973 patients(77.5%) with a previous cesarean birth had a spontaneous onset of labor. Labor was induced in 283 patients(22.5%) with a previous cesarean birth. Successful vaginal delivery rate were 82.9%(807/973) in spontaneous labor and 79.2%(224/283) in induced labor group (p= NS). There were no differences in uterine dehiscence and rupture rate, perinatal and maternal mortality rate, and the rate of infants with low 1 or 5-minute Apgar scores between patients attempting a trial of labor after cesarean, spontaneous and induced. CONCLUSION: we conclude that labor induction in patients with a previous low transverse cesarean section is a safe procedure requiring close peripartum maternal and fetal surveillance.
Cesarean Section ; Female ; Gwangju ; Humans ; Infant ; Jeollanam-do ; Korea ; Labor, Induced ; Maternal Mortality ; Parturition* ; Peripartum Period ; Pregnancy ; Retrospective Studies ; Rupture ; Trial of Labor