Oral Misoprostol Solution for Induction of Labor in Pre-labour Rupture of the Fetal Membranes in Term Pregnancies
Mostafa Raafat Ali;
Abstract
P
remature or prelabor rupture of membrane (PROM) is defined as rupture of membranes before the onset of labor. It occurs in 5-10% of all pregnancies, 70% of which occur at term.
PROM is multifactorial and complex as it may occur in patients with an incompetent cervix, which can result from previous genital tract surgery or laceration. Also, it occurs with increased frequency in women who smoke or who have unstable lie, multiple gestation, polyhydramnios, or antepartum hemorrhage. However, in the majority of cases, there is no obvious cause. Subclinical intrauterine infections have been proposed as a predisposing factor for PROM.
The clinical management of PROM in term patients remains controversial. Expectant management compared with labor induction in women with term PROM demonstrated that expectant management was associated with a significantly increased incidence of clinical chorioamnionitis, postpartum fever, longer maternal hospital stay, and infant days spent in the neonatal intensive care unit. With these potential risks, induction of labor seems to be the optimal management for women with term PROM. However, induction of an unfavorable cervix causes prolonged labor and increases cesarean section rates.
Patients with unfavorable cervices probably are best managed by induction of labor with prostaglandin compounds.
Misoprostol, a synthetic prostaglandin E1 analogue. A number of published controlled trials have shown that misoprostol is an effective agent for cervical ripening and labor induction in patients at term.
The aim of this study is to compare the efficacy, safety and maternal satisfaction of a dose of 25 µg versus 50 µg oral misoprostol solution in cases of premature rupture of membranes at term.
This study included 140 pregnant women admitted to the casualty ward of the department of Obstetrics & Gynecology at Ain Shams University Maternity Hospital presenting with PROM at term in the period from June 2011 to September 2014.
remature or prelabor rupture of membrane (PROM) is defined as rupture of membranes before the onset of labor. It occurs in 5-10% of all pregnancies, 70% of which occur at term.
PROM is multifactorial and complex as it may occur in patients with an incompetent cervix, which can result from previous genital tract surgery or laceration. Also, it occurs with increased frequency in women who smoke or who have unstable lie, multiple gestation, polyhydramnios, or antepartum hemorrhage. However, in the majority of cases, there is no obvious cause. Subclinical intrauterine infections have been proposed as a predisposing factor for PROM.
The clinical management of PROM in term patients remains controversial. Expectant management compared with labor induction in women with term PROM demonstrated that expectant management was associated with a significantly increased incidence of clinical chorioamnionitis, postpartum fever, longer maternal hospital stay, and infant days spent in the neonatal intensive care unit. With these potential risks, induction of labor seems to be the optimal management for women with term PROM. However, induction of an unfavorable cervix causes prolonged labor and increases cesarean section rates.
Patients with unfavorable cervices probably are best managed by induction of labor with prostaglandin compounds.
Misoprostol, a synthetic prostaglandin E1 analogue. A number of published controlled trials have shown that misoprostol is an effective agent for cervical ripening and labor induction in patients at term.
The aim of this study is to compare the efficacy, safety and maternal satisfaction of a dose of 25 µg versus 50 µg oral misoprostol solution in cases of premature rupture of membranes at term.
This study included 140 pregnant women admitted to the casualty ward of the department of Obstetrics & Gynecology at Ain Shams University Maternity Hospital presenting with PROM at term in the period from June 2011 to September 2014.
Other data
| Title | Oral Misoprostol Solution for Induction of Labor in Pre-labour Rupture of the Fetal Membranes in Term Pregnancies | Other Titles | استخدام محلول عقار الميزوبروستول عن طريق الفم فى تحفيز الولادة فى حالات الانفجار المبكر لأغشية السائل الأمنيوسى لجنين مكتمل النمو | Authors | Mostafa Raafat Ali | Issue Date | 2015 |
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