A prospective randomized comparative study of the efficacy of sustained release vaginal insert versus intracervical gel in primigravidae at term pregnancy

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dc.contributor.authorThupakula, Thejaswi R.en_US
dc.contributor.authorMakhija, Belaen_US
dc.contributor.authorHaritwal, Arpanaen_US
dc.date.accessioned2020-10-16T08:03:41Z
dc.date.available2020-10-16T08:03:41Z
dc.date.issued2020-04
dc.description.abstractvBackground: Induction of labour is the intentional initiation of labour before spontaneous onset for the purpose of delivery of fetoplacental unit. Failure of induction is responsible for increased incidence of caesarean delivery. This study performed to assess and compare the clinical effects of sustained release vaginal insert versus intracervical gel in primiparous women with term pregnancy in terms of improvement of Bishop’s score, Induction delivery interval, incidence of hyperstimulation, maternal and neonatal outcomes.Methods: A total 100 consecutive term pregnant women who underwent labor induction for fetal or maternal indications were divided randomly into two groups. Group A - sustained release Vaginal insert and Group B - Intracervical gel. Informed consent was taken from each patient.Results: Statistically significant increase in final Bishop’s score (p=0.008) and hyperstimulation (p=0.04) was seen in Vaginal insert group as compared to Intracervical gel group, while there were no statistically significant differences in maternal outcomes, neonatal outcomes and need for oxytocin augmentation in both groups.Conclusions: In this study we found that insert did not improve the induction delivery interval or rate of successful induction, nor did it have any advantage in terms of neonatal outcome although it did improve the Bishops score – Its advantage was in terms of single application, few prevaginal examinations, longer duration of action and immediate retrieval in case of hyperstimulation. Its main drawback remained the maintenance of cold chain without which its efficacy decreases. Another significant observation was the dropout rate of insert (16%).en_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynecology, Max Smart Super-Speciality Hospital, Saket, New Delhi, Indiaen_US
dc.identifier.citationThupakula Thejaswi R., Makhija Bela, Haritwal Arpana. A prospective randomized comparative study of the efficacy of sustained release vaginal insert versus intracervical gel in primigravidae at term pregnancy. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2020 Apr; 9(4): 1532-1539en_US
dc.identifier.issn2320-1770
dc.identifier.issn2320-1789
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/207591
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber4en_US
dc.relation.volume9en_US
dc.source.urihttps://dx.doi.org/10.18203/2320-1770.ijrcog20201218en_US
dc.subjectBishops scoreen_US
dc.subjectDinoprostoneen_US
dc.subjectHyperstimulationen_US
dc.subjectInduction of laboren_US
dc.titleA prospective randomized comparative study of the efficacy of sustained release vaginal insert versus intracervical gel in primigravidae at term pregnancyen_US
dc.typeJournal Articleen_US
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