Professional paper
OUTCOME AND DURATION OF INDUCED DELIVERIES IN GENERAL HOSPITAL BJELOVAR
Tibor Toth
Alen Šelović
Abstract
The aim. There were many comparative studies about induction of deliveries, but they are still object of discussion. The aim of this study was, using retrospective analysis, to determine the differences in succes of induction of delivery between two methods: oxytocin plus amniotomy versus oxytocin plus amniotomy after previous local prostag¬landine application. Patients and methods. In the period between 1997–2001 in Maternity department of General hospital Bjelovar there were 909 induced (19.09%) out of 4640 deliveries. In 159 (17.5%) of these cases modified Bishop index was unfavourable (<5), in 472 (51.9%) relatively favourable (5–8), and favourable (>8) in 278 (30.6%) cases. 339 (37.3%) parturients were primiparas, 315 (34.6%) II-paras and 255 (28.1%) >II-paras. Oxytocin with amniotomy was used as the only method of induction in 786 (86.5%) of cases. Combination, oxytocin with amniotomy after previous application of Prepidil® gel was used in 45 (4.9%) cases, in 62 inductions (6.8%) after application of Prostin® vaginal tablets and in 16 (1.8%) cases after application of Prostin® vaginal gel. Results. Induced programmed deliveries (N=604) were accomplished vaginaly in 565 (93.5%) and induced indicated deliveries (N=305) in 246 (80.7%) cases. Deliveries which were induced by prostaglandins were more successfull and less lasting than deliveries which were induced only by oxytocin and amniotomy. Statistically was found signifficant difference in Bishop index and parity influence (p<0.05). Deliveries induced¬ after previous cesarean section were accomplished vaginaly in 83.3% after application of Prepidil® gel, and in 58.3% in those induced by oxytocin and amniotomy. Perinatal mortality in induced deliveries was 1.1‰. There was not registered any case of uterine hypertonus, uterine rupture or puerperal sepsis. Conclusion. The use of local prostaglandine in induced deliveries with immature and relative immature uterine cervix is superior method than induction only with oxytocin and amniotomy. To foreseeing the succes between two methods of induction, and considering the costs of induction means, there is a need to find more objective diagnostic method than Bishop cervical index.
Keywords
induction of delivery; prostaglandin E2; oxytocin
Hrčak ID:
15518
URI
Publication date:
1.3.2003.
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