Dr. Mussarat Ashraf, Assistant Professor, Department of Obstetrics and Gynaecology, PAEC General Hospital, Islamabad.

ABSTRACT

Objective: in this study we compared the efficacy of conventional dinoprostone alone and concurrent oxytocin with dinoprostone in reducing induction delivery interval in primigravida at term. Minimizing induction delivery interval will result in improved maternal satisfaction with birth process and less hospital cost by reducing hospital stay.
It was hypothesized that the concurrent method of labour induction would lead to shorter induction to delivery time without any adverse foetal or maternal effects.
Study Design: a randomized controlled trial.
Place & duration of study: department of Obstetrics and Gynaecology, PAEC General Hospital, Islamabad from August 1st, 2009 to January 31st, 2010.
Methodology: eighty pregnant women at term were randomly assigned to either dinoprostone and concurrent oxytocin group (Group A, n=40) or dinoprostone alone with placebo group (Group B, n=40). Induction delivery interval, mode of delivery, maternal complications (e.g. hyperstimulation) and foetal complications (e.g. NICU admission and APGAR score after birth of neonate) were studied.
Results: It was found that induction to delivery interval in concurrent oxytocin group (Group A) was significantly reduced as compared to dinoprostone alone group (Group B). In group ‘A’ 22.5% patients delivered in 3-5hrs while in only 7.5% patients induction delivery interval was 10-16hrs as compared to group ‘B’ where 25% patients delivered in 10-16hrs (p value 0.026). The operative delivery i.e. lower segment caesarean section (LSCS) was performed in 27.5% and 32.5% patients in group ‘A’ and group ‘B’ respectively.
Hyperstimulation rate in group ‘A’ was slightly higher (5% patients) than group ‘B’( 2.5% patient). There was no statistically significant difference in APGAR score and Neonatal Intensive Care Unit (NICU) admissions in babies born in both groups.
Conclusion: induction delivery interval in concurrent method of induction was significantly less as compared to dinoprostone alone group without increasing foetomaternal risks.
Keywords: term, Primigravida, Dinoprostone, Induction of labour, Induction delivery interval, Concurrent oxytocin

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