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OXYTOCIN ALONE VERSUS DINOPROSTONE INSERT FOLLOWED BY OXYTOCIN FOR INDUCING LABOUR IN TERM PRELABOUR RUPTURE OF MEMBRANES

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Divith Khagraj, Keerti Kongutti, Deepika N
» doi: 10.53555/ejmcm/2024.11.05.04

Abstract

Introduction: Immediate induction in Term Prelabour rupture of membranes (PROM) decreases infectious morbidity in mother and baby. Induction of labour in Term PROM with unfavourable cervix can be done directly with oxytocin or by first priming the cervix with prostaglandins followed by oxytocin augmentation if needed. Direct oxytocin induction leads to shorter induction to delivery interval but increases caesarean delivery. Objective: To compare the induction to delivery interval and feto-maternal outcome in women with Term PROM and unfavourable cervix induced with Oxytocin versus Dinoprostone (PGE2) Vaginal insert followed by oxytocin. Methods: This was a randomized comparative study including 150 low risk pregnant women with term PROM and poor bishops score, done over a period of 18 months, women were randomized into 2 groups of 75 each after obtaining informed consent. Women in group-A were induced with Oxytocin directly while Group-B were first primed with dinoprostone vaginal insert followed by oxytocin induction/augmentation if needed. All women were followed for induction to delivery interval and feto-maternal infectious morbidity. Results: Induction to delivery interval and hospital stay was significantly shorter in group A as compared to group B, 11.4 hours & 18.3 hours, p <0.001 and 75.12 hours & 90.48 hours, p <0.001 respectively. The caesarean rate was similar in both groups, p=0.546. There was no feto-maternal infectious morbidity in the study population. Conclusion: Direct oxytocin induction in term PROM results in shorter induction delivery interval and shorter duration of hospital stay without increasing caesarean rate.

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