A COMPARATIVE STUDY OF ADDING FIRST DOSE OF INTRACERVICAL DINOPROSTONE IN MISOPROSTOL REGIMEN AND SUBLINGUAL MISOPROSTOL ALONE FOR INDUCTION OF LABOUR

Background: Induction of labor is characterized as the course of misleadingly animating the uterus to begin labor. In around 5 to 25% of pregnancies, there comes a stage when the embryo or the mother would be better if the birth is directed. Prostaglandins change the extracellular principal substance of the cervix, mature the cervix & furthermore increment the movement of collagenase in the cervix. They additionally permit an increment in intracellular calcium levels, causing withdrawal of the myometrial muscle. As of now, there are two prostaglandin analogs accessible for cervical aging: Misoprostol & Dinoprostone Gel. The method of administration that has been explored thoroughly is endocervical Dinoprostone or prostaglandin E2. Though this is widely used, it is expensive and required refrigeration for storage with warming before use. It was only a matter of time before a comparably cheap, safe and effective vaginally administered Prostaglandin with limited side effects would be available and Misoprostol or PGE1 tablet tted those criteria admirably. Material And Methods: The present study is a case control study done in the Department of Obstetrics and Gynecology, M.G.M Medical College and M.Y Hospital, Indore, over a period of 1 year from August 2020 to August 2021. All cases induced in Department of Obstetrics and Gynaecology, M.G.M Medical College and M.Y Hospital, Indore. The study will include prospective cases for 1 year from ethics committee with Sample Size of 400 patients. 1. 200 patient with an indication for labour induction received with 25ug of sublingual misoprostol & repeated for a maximum of 6 doses every 4 hours as needed. 2. 200 patients with an indication for induction of labour received 0.5 mg intracervical dinoprostone gel followed by 25ug of sublingual misoprostol & repeated for a maximum of 4 doses every 4 hours as needed. Results: During the study period maximum induction were done in the age group of 21-23 years booked patients, in multiparas, at 39 weeks gestation, with common indications of postdated pregnancy, PROM, hypertensive disorders of pregnancy, with BISHOPS score < 4. More than 80% patients achieved vaginal delivery in both groups, however in group 2 fetal distress was more common. Conclusion: study concluded that adding dinoprostone gel to misoprostol regime was safe; led to increased induction delivery interval as compared to misoprostol regime without adding additional risk to the mother or fetus; with additional benet of reducing the risk of tachysystole in mother; led to less fetal distress with need of operative intervention; led to increased induction delivery interval but the APGAR scores were comparable in both the groups.