research centers


Search results: Found 14

Listing 1 - 10 of 14 << page
of 2
>>
Sort by

Article
Glyceryl Trinitrate Versus Misoprostol for Termination of First Trimester Missed Miscarriage

Authors: Ibtissam Y.Al-Saffar --- Eman Marouf
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 3 Pages: 242-248
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

Loading...
Loading...
Abstract

ABSTRACT:BACKGROUND:Missed abortion refers to a pregnancy that can manifest as an anembryonic gestation or fetal demise prior to 20 weeks' gestation. Medical management has been used as a treatment options.A common medical regimen used to evacuate the uterus is vaginal misoprostol (Cytotec) in single or multiple doses.OBJECTIVE:To compare the therapeutic efficacy and adverse effects of intravaginal administration of a nitric oxide donor (glyceryl trinitrate) with that of a prostaglandin (misoprostol) to induce cervical changes in women with missed miscarriages to terminate their pregnancies.METHODS:A prospective, randomized comparative trial conducted at Al-Yarmouk Teaching Hospital, Department of Obstetrics & Gynaecology/ Baghdad-Iraq, enrolled Sixty women with first trimester missed miscarriages that requested pregnancy termination. They were randomly selected to receive either two tablets of 500 μg glyceryl trinitrate vaginally (n = 30) or 200 μg misoprostol tablet vaginally (n = 30), every 3 hours to a maximum of four doses or until reaching desirable cervical changes. Baseline vital signs were recorded and repeated with monitoring for adverse side effects every 3 hours until finishing therapy.RESULT:The difference in cervical changes between the two groups was statistically not significant (p > 0.05). The successful outcome taken as cervical dilatation ≥ 10 mm, incomplete, or complete miscarriage was achieved in 30% of women in the glyceryl trinitrate and in 53% of women in the misoprostol group which was statistically not significant ( p>0.05).Systolic & diastolic blood pressure, temperature & heart rate were lower with glyceryl trinitrate than misoprostol, but the differences were not significant (p>0.05).The most frequent side effect associated with glyceryl trinitrate administration was headache, which occurred in 27/30 women, compared with only 5/30 women in misoprostol group; relative risk 5.42 (p <0.05). Women treated with misoprostol reported mainly lower abdominal pain; relative risk 4.2 (p <0.05).CONCLUSION:Although glyceryl trinitrate was less effective than misoprostol when used prior to termination of missed miscarriage, the difference was statistically not significant. Moreover glyceryl trinitrate caused less adverse effects than misoprostol and it could have a role in the management of this obstetrical problem.


Article
11- EXTRA-AMNIOTIC SALINE VERSUS EXTRAAMNIOTIC MISOPROSTOL FOR RIPENING THE UNFAVORABLE CERVIX

Author: Ali F Al-Assadi
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2011 Volume: 17 Issue: 1 Pages: 72
Publisher: Basrah University جامعة البصرة

Loading...
Loading...
Abstract

Ali F Al-AssadiFICOG, CABOG. Assist. Prof., Dept. of obstetrics & gynecology, Basrah Medical College.AbstractThis study aimed to compare the efficacy of two methods (extra-amniotic saline instillation andextra-amniotic misoprostol) for ripening the unfavorable cervix.The study was set at the labour room in Basrah Maternity (teaching) hospital with 300 bedcapacity.It is a prospective comparative study conducted to compare extra-amniotic saline instillationand extra-amniotic Misoprostol for ripening the unfavorable cervix.Group I (Extra-amniotic saline instillation): Foley’s catheter with extra-amniotic normal salineinstillation at a rate of 1ml/min.Group II (extra-amniotic Misoprostol): The cervix was ripped with 25mcg. Misoprostol injectedextra-amniotically using a Foley’s catheter.The clinical trial involved a total (121) pregnant women, in group I (57) and in group II (64). Thesuccess rates in achieving cervical ripening were 100% for both groups. The mean post ripeningBishop’s score in group II (primigravidae (7.5 ± 1.5), multigravidae (7.86 ± 1.39)) weresignificantly higher than those in group I (primigravidae (6.01±0.4), multigravidae (6.07± 0.47)).The mean ripening time (hrs) in group II (primigravidae (6.15± 2.1), multigravidae (4.03± 1.3))were significantly shorter than those in group I (primigravidae (7.71± 1.02), multigravidae (6.4±1.02)). The mean induction-delivery time (hrs) in group II (primigravidae (5.3± 2), multigravidae(3.8± 1.4)) were significantly shorter than those in group I (primigravidae (7,7± 2.03),multigravidae (5.92± 1.9)). The vast majority of women under study had vaginal delivery (80.7%in group I and 96.8% in group II).In conclusion, EAM was quick and effective method for ripening the cervix, it requires littletraining for application so that it is a suitable method for patients who require rapid induction oflabour.


Article
The Use of Vaginal Misoprostol in the Management of Early Pregnancy Failure Up to Eight Weeks Gestation on an Outpatient Basis
استعمال عقار الميزوبرستول عن طريق المهبل لمعالجة فشل الحمل المبكر دون عمر الثماني أسابيع للمريض الخارجي

Author: Fadia Jassim Al-izzi د.فاديه جاسم محمد العزي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2010 Volume: 23 Issue: 4 Pages: 302-306
Publisher: Al-Mustansyriah University الجامعة المستنصرية

Loading...
Loading...
Abstract

Abstract:Background: the medical management is an effective alternative in the management of early pregnancy failure and this may be undertaken successfully on an outpatient basis. This study is a single arm prospective study designed to use one of regimen of medical termination of early pregnancy failure up to 8 weeks gestation on outpatient basis.Patients & Methods: In Al-Yermouk Teaching Hospital-Outpatient Clinic, a total of 100 women with an early pregnancy failure were enrolled in this study, all of them were below 8 weeks gestation, they had Hb more than 10 gm /l, haemodynamically stable, no history of clotting disorder or were using anticoagulant (aspirin not included), no previous scar, Rh positive group and they had no previous attempt to terminate the current pregnancy with other obstetricians. Four 200 microgram tablets (800 micro.) of misoprostol (cytotec) were inserted into posterior fornix through a speculum. A second dose was given after 24 hours if expulsion of the products of conception was not complete. On day 8(range, 6-10), if the expulsion of products of conception was still not complete, surgical evacuation was offered. The women were returned on day 15 for assessment including hemoglobin level and ultrasound.Results: A total of 100 women were enrolled. The mean age was 29.5±7.3 years. The mean gestational age was 40.96±3.20days; 86% were successfully treated and aborted by day 8. Two patients refused surgical evacuation by day 8 after they failed to response to medical management, with follow up they showed a response by day 15. The other (12%) needed surgical evacuation. Two women had been hospitalized as emergency cases, one with bleeding; the second one was admitted because of endometritis. 5% of women recorded fever after misoprostol, 26% had nausea, 11% had vomiting, and 10% had diarrhea. Almost all the patients had abdominal pain but 34% of them used tramadol. 93% were satisfied with medical management, 80% would recommend this treatment for their relatives or they would use it in the future.Conclusion: Two doses of 800 micrograms of misoprostol administered vaginally is an option for the medical management of early pregnancy failure up to 8 weeks gestation on an outpatient basis, with success rate of 88% and tolerable side effects. 93% were satisfied with medical management, 80% of the enrolled women would recommend this treatment for their relatives or they would use it in the future.Key word: Vaginal misoprostol, early pregnancy failure.

الملخصالتقديم:- العلاج الطبي (الغير جراحي) يعتبر بديل فعَال في معالجة فشل الحمل المبكر وهذا يمكن أن يجري بصيغة المريض الخارجي. هذه الدراسة صُممت لتقيم كفاءة, أمان وإمكانية انجاز واحد من البروتوكولات العلاجية الطبية (الغير جراحية) المستخدمة لمعالجة فشل الحمل المبكر وبعمر حمل يقل عن ثمان أسابيع ولمريض خارجي.المرضى والطرق:- مئة امرأة تعاني من فشل الحمل المبكر (إجهاض), عمر الحمل يقل عن ثمانية أسابيع لجميع النساء مع توفر الظروف الآتية: نسبة الدم أكثر من 10 غرام/لتر, ضغط الدم مستقر. لاتستعمل موانع التخثر (ماعدا الأسبرين غير مشمول) ,لا يوجد ندبة سابقة في الرحم, عاملRh موجب ولا توجد محاولة سابقة لمعالجة الإجهاض. أربعة حبوب من فئة 200 مايكرو غرام من عقار ميزوبرستول (سايتوتك) وضعت في الجزء الخلفي من المهبل عن طريق منظار توسيعي. جرعة ثانية أعطيت بعد 24 ساعة إذا لم يحدث إنزال في أجزاء الحمل. في اليوم الثامن ( يتراوح من 6-10) يتم تفريغ الرحم جراحيا أذا لم يتم إنزال أجزاء الحمل بصورة كامله. تعود المرأة في اليوم 15 لغرض المتابعة وإجراء فحص السونار ونسبة الهيموكلوبين. النتائج:- مئة أمرأه دخلوا في هذه الدراسة , متوسط أعمار النساء كان 29.5 ±7.3 سنة. وأفضل تقدير لعمر الحمل كان اقل من ثمانية أسابيع.في 86% من النساء تمت معالجة الحالة بنجاح قبل اليوم الثامن. اثنان من النساء رفضن العملية الجراحية في اليوم الثامن وقبل اليوم الخامس عشر حدث إسقاط كلي. 12% من النساء احتجن إلى عملية جراحية بحلول اليوم الثامن. اثنان من النساء ادخلن إلى المستشفى كحالة طارئة؛ واحدة بسبب النزف والأخرى بسبب التهاب بطانة الرحم. 5% من النساء سُجلت لديهن حرارة بعد استعمال ميزوبرستول, 26% غثيان, 11% تقيؤ و10% إسهال. تقريبا معظم النساء كان لديهن آلام في البطن ولكن 34% فقط استعملت مهدئ تراما دول. 93% من النساء كن راضيات عن الدواء, 80% سوف يوصين أقاربهن أو سوف يستعملن هذه الطريقة في المستقبل. الاستنتاج:- جرعتان من ميزوبرستول (800 مايكرو غرام للجرعة الواحدة) تعطى عن طريق المهبل هي طريقة يمكن استعمالها لمعالجة وممكن إجراءها للمريض الخارجي لإنهاء فشل الحمل المبكر وبعمر اقل من ثمان أسابيع وبنسبة نجاح 88%. 93% من النساء كن راضيات عن الدواء, 80% سوف يوصين أقاربهن أو سوف يستعملن هذه الطريقة في المستقبل.


Article
MISOPROSTOL EFFICACY IN LABOR INDUCTION

Authors: Asma Z. Fadhil اسمى زهير فاضل --- Edwar Z. Khosho ادور زيا خوشو
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2014 Volume: 12 Issue: 2 Pages: 114-118
Publisher: Al-Nahrain University جامعة النهرين

Loading...
Loading...
Abstract

Background:The process of normal human childbirth is categorized in three stages of labor: the shortening and dilation of the cervix, descent and birth of the infant, and delivery of the placenta. Oxytocin is the most commonly used agent for induction, and is used to induce uterine contractions.Objective:To estimate the efficacy of oral misoprostol for labor induction.Methods:This randomized, controlled trial study was comparing intravenous oxytocin to a 25-microgram dose of oral misoprostol every 3-4 hours. A woman who had cervical dilation of 0-2 cm then undergoes labor induction. Our outcome was recorded.Results:we found when we used misoprostol the time duration was significantly less specially in primigravida and when os closed, the side effect approximately same as oxytocin.Conclusion:Oral misoprostol is an effective agent for inductionof labor.Keywords:Induction of labor, misoprostol, oxytocin


Article
A comparison between two different doses of sublingual misoprostol in the management of first trimester incomplete miscarriage
مقارنة بين جرعتين مختلفتين من الميزوبروستول تحت اللسان في إدارة الإجهاض الناقص في الأثلوث الأول

Authors: Mina J. Mustafa --- Ishraq M. Shakir
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2016 Volume: 20 Issue: 1 Pages: 1260-1266
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

Loading...
Loading...
Abstract

Background and objective: Various methods have been described for management of first trimester incomplete miscarriage. The active methods include surgical methods that are highly effective but are associated with anesthetics and surgical risks. Medical methods by Misoprostol had been shown to be effective, acceptable and widely used treatment for incomplete miscarriage. The aim of this study was to compare the efficacy, patients' acceptability and the side effects of sublingual administration of single dose of 400mcg with single dose of 600mcg of misoprostol in the treatment of first trimester incomplete miscarriage. Methods: This study was conducted from April 1st, 2011 to February 1st, 2012 in the Maternity Teaching Hospital in Erbil city, Kurdistan region, Iraq. The study included 120 patients with incomplete miscarriage at a gestational age ≤12 weeks. They randomly received either single dose of 400mcg or 600mcg of misoprostol sublingually. Patients returned for follow-up and re-evaluation of abortion status after 7 days. Patients with a continuous incomplete miscarriage underwent surgical evacuation. Results: The success rate in the first and second group was 90% and 91.7%, respectively, while patients' acceptability in the first and second group was 96.7% and 95%, respectively with no difference between both groups. Gastrointestinal side effects like nausea and diarrhea were more in the second group. Conclusion: Single dose of 400 mcg of sublingual misoprostol is preferred on 600mcg of sublingual misoprostol regarding the development of side effects.


Article
Comparison of Oral Misoprostol with Conventional Uterotonics in the Management of Third Stage of Labor

Authors: Hameedah Hadi --- Zahida A. Al- Saadi
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2019 Volume: 12 Issue: 1 Pages: 4103-4110
Publisher: Kerbala University جامعة كربلاء

Loading...
Loading...
Abstract

background: Randomized prospective control study it is objective to compare effect of oral misoprostol with conventional uterotonics in the management of the third stage of labor.Aim of study: The incidence of Hemorrhage and the decrease in hemoglobin concentration is the main out comes of the trial. Secondary outcomes included the occurrences of sever postpartum hemorrhage.Patient and method: This study was done in Department of obstetrics and gynecology at Baghdad Teaching Hospital. In controlled trials a pregnant women total number 280 were randomized into four groups, as followed: Group I: received oral misoprostol 400 Mg, followed by two doses of oral misoprostol 100 Mg 4hours a part. (n=72), group 2: received intravenous infusion of oxytocin10 IU plus oral misoprostol 400 Mg followed by two doses of 100Mg oral misoprostol 4 hours apart group 3: received intravenous infusion of oxytocin 10 IU. (n=69), group 4: received intravenous infusion of 10 IU oxytocin plus intramuscular administration of methylergometrine (methergine) 0.2 mg. (n=77). The data of 40 women were excluded from the study because of loss to follow up, previous cesarean deliveries performed after randomization n=25, pre delivery hemoglobin was unavailable n= 10, postpartum percentage of hematocrit unavailable n=5. Main measures, the incidences of postpartum hemorrhage and the changes in hematocrit concentration from before delivery to 24 hours postpartum, in those women used oral misoprostol in management of third stage of labor with or without the use of other uterotonicsResult: Shows, Mean blood loss in misoprostol group was not significantly higher than blood loss in oxytocin group and oxytocin misoprostol group, but there was statistically significant difference when compared with oxytocin-methylergometrine group.Conclusion: Oral administrated misoprostol is as effective as conventional oxytocic in prevention of postpartum hemorrhage


Article
Misoprostol for termination of first trimester missed abortion

Author: Maha Assim AL- Azzawy مها عاصم العزاوي
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2009 Volume: 5 Issue: 7 Pages: 121-141
Publisher: Al-Qadisiyah University جامعة القادسية

Loading...
Loading...
Abstract

Background: misoprostol is prostaglandin E1 analogue that can be given by oral, sublingual, vaginal or rectal route. It is cheap and can be stored at room temperature and because of its utero-tonic action, it become an important drug in obstetric and gynecological practice.Objectives: to evaluate the effectiveness of intravaginal followed by oral misoprostol tablets for medical termination of missed abortion between 8 – 13 weeks.Methods : a prospective study of (60) women with diagnosed missed abortion admitted to AL- Zahraa General hospital – Wassit Governorate Iraq from July 2006 through July 2007 . 800 micrograms (4 tablets) of misoprostol inserted in the posterior fornix of the vagina after moisture with normal saline followed by oral 400 micrograms (2 tablets) 6 hours later. Another 400 micrograms were given orally 6 hours from the last dose for those patients whodid not respond to the previous two doses.Results: (48) patients (80%) had complete expulsion . (21) Patients (35%) after the vaginal dose. (15) Patients (25%) respond after the first oral dose and (12) patients (20%) after the second oral dose. (6) Patients (10%) had incomplete abortion; the remainder (6) patients (10%) failed to respond within 24 hours of starting treatment and require surgical evacuation. The mean time for expulsion was 10 hours. Conclusion: first trimester missed abortion medical termination by misoprostol is effective, save and a practical Methods .

الميزوبرستول هو مثيل البروستوكلاندين- اي 1 ويمكن ان يعطى عن طريق الفم وتحت اللسان و عن طريق المهبل وعن طريق الشرج. يعتبر هذا العقار رخيصا و ممكن خزنه في درجة حرارة الغرفه و بسبب فعاليته في احداث تقلصات رحميه اصبح عقارا مهما في مجال النسائيه و التوليد.الهدف من الدراسة هو لتقييم فعالية الميزوبرستول وذلك بأعطائه عن طريق المهبل يليه اعطائه عن طريق الفم لانهاء الاسقاط المنسي طبيا بين 8 – 13 اسبوع. هذهِ دراسه مستقبليه تضمنت ستون امرأه مشخصه بحالة اسقاط منسي ادخلوا مستشفى الزهراء العام في محافظة واسط / العراق للفتره بين تموز 2006 و تموز 2007 . 800 مايكروكرام ( اربع حبوب) من الميزوبرستول توضع في الجزء الخلفي من المهبل بعد ترطيبها بالنورمال سلاين تليها جرعه عن طريق الفم (400 مايكروكرام) بعد ستة ساعات . وجرعه فمويه اخرى بعد ستة ساعات من الجرعه الاخيره للمرضى الذين لم يستجيبوا للجرعتين الاوليتين.النتائج 48 مريضه (80%) حصل اسقاط كامل. 21 منهن(35%) بعد الجرعه الاولى. 15مريضه (25% ) بعد الجرعه الفمويه الاولى و 12 مريضه (20%) بعد الجرعه الفمويه الثانيه .6مريضات (10%) انتهوا بأسقاط ناقص و 6 مريضات (10%) لم يستجيبوا للعلاج بعد مرور 24 ساعه على بدأ العلاج واحتاجوا الى تداخل جراحي لانهاء الحمل. كان معدل وقت انهاء الاسقاط المنسي هو عشرة ساعات .يستنتج من الدراسة انهاء الحمل الطبي في حالات الاسقاط المنسي في الجزء الاول من الحمل بواسطة الميزوبرستول هي طريقه فعاله و امينه وعمليه.


Article
EVALUATION OF THE GASTROPROTECTIVE EFFECT OF MISOPROSTOL, CHITOSAN AND THEIR COMBINATION ON INDOMETHACIN INDUCED GASTRIC ULCER IN RATS.
تقييم التأثير المضاد لقرحة المعدة للميزوبروستول والكايتوسان وتوليفهما على قرحة المعدة المحدثة بواسطة الاندوميثاسين في الجرذان

Loading...
Loading...
Abstract

ABSTRACTBackground: The study was designed to evaluate the anti-ulcer effect of chitosan, misoprostol, and their combination on gastric ulceration induced by indometacin in rats.Methods and experimental design: Chitosan was prepared from shrimp shells waste products. Thirty rats were divided into 5 groups, 6 rats each. Rats in group 1 (control) were given solid sugar and distilled water for 3 days; group 2 were treated by indometacin (25mg/rat) ; group 3,4, and 5 were treated by misoprostol, chitosan, and by the combination chitosan and misoprostol respectively before treatment with indometacin. Blood were collected before sacrificing the animals and used for estimation of MDA, a marker of oxidative stress. The stomachs were prepared for estimating the total gastric area, ulcerated area, tissue MDA, mucin production as well as for histopathological examination.Results: Indometacin produced gastric ulcers, and increased the total gastric area in all animals. These effects were associated with a significant elevation of MDA levels in the blood and in stomach tissues, and a significant reduction in mucin production. Misoprostol, chitosan and their combination protected gastric mucosa since they significantly reduced ulcer index. Moreover, the observed anti-ulcer effect was more with the combination in comparison to monotherapy of misoprostol or chitosan.Treatments by misoprostol, chitosan and their combination before indometacin significantly reduced blood and tissue MDA levels and increased mucin production.Conclusion: Chitosan, misoprostol and their combination have gastroprotective effects against indometacin-induced gastric ulceration in rats.

1 فرع الأدوية/كلية الطب/جامعة البصرة، 2قسم الفسلجة والأدوية/كلية الطب البيطري/جامعة و قسم الفسلجة والأدوية/كلية الطب البيطري/جامعة البصرةهدف الدراسة: صممت هذه الدراسة لتقييم التأثير المضاد للقرحة للميزوبروستول والكايتوسان وتوليفهما على قرحة المعدة المحدثة بواسطة الأندوميثاسين في الجرذان. الطرائق وتصميم التجربة: تم تحضير الكايتوسان من قشور الروبيان وقسمت 30 من الجرذان إلى خمس مجاميع, ستة جرذان كل منهما. أعطي الجرذان غي المجموعة الأولى (مجموعة السيطرة) السكر الصلب مع الماء لمدة ثلاثة أيام, وعولجت المجموعة الثانية بالأندوميثاسين. والمجموعة الثالثة والرابعة والخامسة تمت معالجتها بالميزوبروستول والكايتوسان وتوليفها على التوالي قبل الأندوميثاسين . وتم جمع الدم قبل التضحية بالحيوانات واستعمل الدم لقياس المالوندايلديهايد. تم تحضير المعدة لقياس مساحة المعدة الكلية والمساحة المتقرحة و المالوندايلديهايد في النسيج وفي الدم, وإنتاج المخاط بالإضافة إلى الفحص النسجي المرضي. النتائج: تسبب الأندوميثاسين في تقرحات معدية وفي زيادة المساحة الكلية للمعدة في كل الحيوانات. هذه التأثيرات كانت مصاحبة بارتفاع معتد في مستويات المالوندايلديهايد في الدم وفي أنسجة المعدة وفي إنقاص معتدّ في إنتاج المخاط, وتمت حماية مخاطية المعدة بواسطة الميزوبروستول والكايتوسان وتوليفها بشكل إنقاص معتدّ في منسب التقرح كما لوحظ إن التأثير المضاد للقرحة كان اكبر عند استعمال توليف الميزوبروستول أوالكايتوسان كل على حدة. أن المعالجة بالميزوبروستول والكايتوسان وتوليفها قبل الأندوميثاسين قلل بشكل معتدّ مستويات الأندوميثاسين في الدم والأنسجة بوصفه معلم للجهد التأكسدي كما سببت زيادة في إنتاج المخاط. الاستنتاج: يمكن إن يستنتج إن لدى الكايتوسان والميزوبروستول وتوليفها تأثيرات حماوية للمعدة ضد تقرحات المعدة المحدثة بواسطة الأندوميثاسين في الجرذان. المجلة الطبية لجامعة البصرة ص1-8

Keywords

indomethacin --- gastric ulcer --- rat --- misoprostol --- chitosan --- mucin


Article
Isosorbide Mononitrate versus Misoprostol for Cervical Ripening

Author: Abdul Razaq
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2012 Volume: 8 Issue: 1 Pages: 69-74
Publisher: Baghdad University جامعة بغداد

Loading...
Loading...
Abstract

Objective: To compare the efficacy and safety of isosorbide mononitrate (IMN) versus misoprostol used to induce labour for overdue pregnancy.Setting: A prospective randomized clinical study conducted at AL-Elwiya Maternity Teaching Hospital in Baghdad from Jan. 2008 to Dec. 2008.Method: One hundred and fifty women with over due pregnancy (past date and posterm pregnancy) referred for induction of labour with Bishop scores <_ 5 were randomly allocated to receive either forty mg isosorbide mononitrate (IMN) tablet as a single vaginal dose (n=75) or fifty mcg misoprostol vaginally (n=75) every six hrs for a maximum of three doses. Amniotomy and/or oxytocin infusion is considered when Bishop scores frankly progressed (augmentation) or used when no improvement achieved after 24 hour (induction). Adverse effects of medications, induction - delivery interval, mode of delivery and neonatal outcome were recorded and subjected to statistical analysis.Results: Isosorbide mononitrate was associated with less adverse effects than misoprostol especially regarding uterine tachysystol (0 with isosorbide mononitrate vs 12% with misoprostol, P<0.01) and hyperstimulation (0 with isosorbide mononitrate vs 16% with misoprostol, p<0.01) but the induction - delivery interval with isosorbide mononitrate group was significantly longer compared with misoprostol (26.3±7.3hrs vs 15.4±5.4 hrs , p<0.01). Oxytocin was added to 70 women (93.3%) used isosorbide mononitrate while to 15 women (20%) used misoprostol (p<0.001). Caesarean rate was not significantly different between the two groups, but the indications were different, dystocia is the major cause (73.3%) with isosorbide mononitrate while persistent non-assuring fetal heart rate pattern (64%) in the misoprostol group.Conclusion: Cervical ripening and induction of labour using isosorbide mononitrate resulted in fewer adverse effects but it was less effective than misoprostol.Key words: Misoprostol, isosorbide mononitrate, cervical ripening, induction


Article
Role of Misoprostol in Induction of Labor: Sublingual versus Vaginal in Tikrit City

Author: Sumaya Tahir Saihood
Journal: Tikret Journal of Pharmaceutical Sciences مجلة تكريت للعلوم الصيدلانية ISSN: 18172716 Year: 2012 Volume: 8 Issue: 2 Pages: 165-171
Publisher: Tikrit University جامعة تكريت

Loading...
Loading...
Abstract

A successful induction of labor leads to vaginal delivery of a healthy baby, in an acceptable time frame with minimum maternal discomfort or side effects. To compare the efficacy and safety of sublingual and per vaginal 25µg misoprostol for labor induction. Primary outcome measures were the number of cases delivering vaginally, Secondary requirement, the incidence of meconium-stained liquor, number of cesarean deliveries, the incidence of hyperstimulation/tachysystole, maternal adverse effects and neonatal outcomes. A prospective study was conducted in Tikrit Teaching Hospital. Indications were reviewed; 416 women randomly received misoprostol 25 µg vaginally and sublingually every three hourly for maximum three doses. Outcomes were analyzed accordingly. The number of the cases who successfully delivered vaginally was greater in the sublingual group. The induction to vaginal delivery interval was significantly shorter in sublingual group. The incidence of tachysystole and meconium-stained liquor were more in the vaginal than in the sublingual group. The mean doses, mode of delivery, oxytocin augmentation and maternal outcomes were significantly favorable in sublingual group. No significant difference is seen in neonatal outcome. Sublingual misoprostol 25 µg administered three hourly for labor induction has better effficacy as compared to 25 µg of vaginal misoprostol.

Listing 1 - 10 of 14 << page
of 2
>>
Sort by
Narrow your search

Resource type

article (14)


Language

English (12)

Arabic and English (2)


Year
From To Submit

2019 (1)

2016 (2)

2015 (1)

2014 (2)

2012 (2)

More...