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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6418.10

Abstract

Context: The complications of prolonged labour are well recognized and the caesarean section has been used in liberally. Although prolonged labour  continues to be a constant problem due to weak uterine contractions or poor cervical dilatation. The problem can be overcome with the ensure the efficacy, adverse effects, safety, and feto-maternal outcome of the Artificial Rupture of Membrane (ARM) and oral misoprostol with ARM and oxytocin infusion for augmentation.

Settings and Design: This prospective study was conducted in the labour room of
NRS Medical College and Hospital Kolkata and included 100 primigravidae women carrying singleton pregnancy at term with spontaneous onset of labour.

Methods and Material: Patients aged between 18 to 28 years, Primigravidae between 37 to 42 weeks of gestational age, Live singleton pregnancy, Cephalic presentation, Spontaneous onset of, Cervical dilatation of 4 cm or more, Inadequate uterine contractions less than three per ten minutes, reassuring foetal heart rate and giving informed consent were included in the study. Each of the agents was applied to every alternate case. Augmentation was done by oral misoprostol 25 mcg at 4-hour interval to maximum of 3 doses (misoprostol group, n=50) Oxytocin infusion was started at the minimum dose of 2mIU/min in Ringer lactate solution, adjusting the dose every 15 minutes till the desired uterine contractions are achieved, with a maximum dose of 5mIU/min at the rate of 15 to 20 drops per minute (oxytocin group, n=50).

Statistical analysis used: Data were expressed as a percentage and mean ± SD. Student’s t-test was used to check the significance of the difference between two
parameters in parametric data. Chi-square test was used to analyse the significance of the difference between the frequency distribution of the data.

Results: The study showed that in both the groups (misoprostol and oxytocin), the majority of the participants belong to the age group of 20-30years. The mean duration of delivery was 5.2 hour and 5.5 hours in misoprostol and oxytocin groups respectively. Prolonged was the major indication for LSCS in both the groups.

Conclusion: Both the agents i.e. oral misoprostol and intravenous oxytocin shortens the duration of effectively and are effective for augmentation of and the need for LSCS was almost similar in both the groups.

Keywords: Oxytocin; Misoprostol; ARM.

Corresponding Author : Subrata Das, Assistant Professor, Department of Obstetrics and Gynaecology, Late Shri Lakhi Ram Agrawal Memorial Government Medical College& KGH Hospital, Raigarh, Chhattisgarh 496001, India.