A COMPARATIVE ANALYSIS OF ORAL PROSTAGLANDIN E2, INTRACERVICAL PROSTAGLANDIN E2 AND INTRACERVICAL EXTRA-AMNIOTIC FOLEY’S CATHETER IN CERVICAL RIPENING FOR INDUCTION OF LABOUR

Abstract

BACKGROUND
Induction of labour is one in which pregnancy is terminated artificially any time after the age of viability by a method that aims to secure delivery per vias naturalis either because of any maternal or fetal indications or involving both irrespective of the outcome. Various methods are adopted for converting an unfavourable cervix to favourable one by simple oxytocin infusion, use of cervical balloons, prosta - glandins in oral, intra vaginal and extra-amniotic routes have been by different workers, success remains a major observation and complication and availability of the method is another important consideration. Use of Foley's catheter by Ezimokhai 30 et al (1980) for cervical ripening prior to induction is very encouraging. The technique is simple and can widely practised in a country like ours.
MATERIAL AND METHOD
Viewed in this context, this prospective study has been undertaken in the Department of O&G, Hitech Medical College and hospital, bhubaneswar from July 2019 to December 2022. The purpose of my study is to compare the efficacy of intra cervical placement of a Foley's balloon catheter, intra cervical prostaglandin E2 & oral Prostaglandin E2 in cervical ripening for induction of labour

RESULT
On comparing the modes of induction, it was found that Spontaneous labour occurred highest in Primiprost group ( 51.62%) followed by Cerviprime group (35.48%) & Foley’s group (20.96%) but the induction in the form of Artificial rupture of membrane, oxytocin infusion or both subsequent to cervical ripening was highest in Foley’s group (79.03%) followed by Cerviprime group (64.5%) &
Primiprost group (48.38%) which was statistically significant.
CONCLUSION
Inflated Foley's catheter for priming of an unfavorable cervix is of proved value but the role in inducing uterine contractility is poor. Prostaglandins are very good inducers of labour but they are not free from side effects like failed induction and foetal jeopardy. Cervical ripening with extra amniotic balloon catheter possesses the advantages of simplicity, low cost, reversibility & lack of severe side effects & so seems to be an ideal method for acceptance where prostaglandins are contraindicated or when uterine hyperstimulation should be avoided such as in cases of intra uterine fetal growth retardation, placental insufficiency, asthmatic
patients, diabetics and so on.