Comparative Analysis of Intracervical Dinoprostone Gel and Vaginal Misoprostol for Labor Induction in a Primigravida at Term
Notice bibliographique
Résumé
Background: The study addresses critical aspects of contemporary obstetric practices regarding labor induction in primigravida at term, focusing on the effectiveness and safety of intravaginal misoprostol (25 µg every 6 h for a maximum of four doses) and dinoprostone gel (0.5 mg every 6 h for a maximum of three doses). Methods: It was a prospective interventional study. Inclusion criteria were: primigravida with an indication for labor induction, gestational age of 37 weeks or more, estimated fetal weight < 3.5 kg, Bishop score < 6 indicating an unfavorable cervix, singleton fetus, cephalic presentation, reactive fetal heart rate pattern, and patient consent. Exclusion criteria were: previous cesarean section uterine surgery, cephalo-pelvic disproportion, malpresentations, evidence of fetal distress pre-induction, grand multipara, fetal anomalies, intrauterine death, allergy to prostaglandins, major degree of placenta previa, and estimated fetal weight > 3.5 kg. Both the agents were compared in terms of: change in Bishop score (depending upon the doses of drugs and contractions), induction to active phase of labor, induction to delivery interval, total duration of labor, intrapartum complications (tachysystole, chorioamnionitis, rupture uterus), mode of delivery, fetal outcome at birth (fetal distress-hypoxia, bradycardia, meconium-stained liquor) Apgar score, postpartum complications like postpartum hemorrhage, and puerperal sepsis. Prospective interventional study was conducted among 200 primigravida women after meeting the strict inclusion and exclusion criteria of the hospital. Groups A and B were randomized with 100 patients each and maternal and fetal outcomes were studied. Partogram was used for monitoring and oxytocin was used as per necessity. Maternal and fetal outcomes were studied. Results: The average gestational age was 38.74 ± 1.03 weeks, with a range of 37 to 41 weeks. The mean pre-induction Bishop score was 4.39 ± 1.02, with scores ranging from 2 to 6. The average total duration of labor experienced by these participants was 13.94 ± 4.43 h. The predominant indication for labor induction was identified as intrahepatic cholestasis of pregnancy (IHCP), accounting for 35.5% of cases. Subsequently, postdatism was the second most prevalent reason at 22.5%, followed by pregnancy-induced hypertension (PIH) at 19.5%. It was noted that the majority of pregnant women, approximately 90%, required only one to two doses of inducing agents, either intravaginal misoprostol or dinoprostone gel. While both agents were effective in initiating labor, intravaginal misoprostol demonstrated superiority in expediting labor progression and reducing the duration of labor. Both the agents exhibited comparable rates of neonatal and maternal complications, highlighting their overall safety and efficacy in clinical practice. In terms of the need for oxytocin in both groups, there was a statistically significant difference demonstrating better efficacy of misoprostol than dinoprostone gel. Conclusions: While both intravaginal misoprostol and dinoprostone gel were successful in inducing labor, our results showed that intravaginal misoprostol was superior in several important areas.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».