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At least 253 records · Page 14Linked to original sources
PubMed1977

Membrane stripping to induce labor.

A group of 91 pregnant women at term were studied randomly to see the effect of digital stripping of the membranes from the lower uterine segment upon the onset of labor. The women with unfavorable cervices (Bishop score 0 to 5) demonstrated a significant increase in the onset of labor within 48 hours as compared to controls. When the cervix was favorable (Bishop score 6 to 10), there was no significant effect. The overall success rate for induction of labor was not significantly altered (43.5% in membrane-stripped patients, 22.2% in controls). There were no major complications of the procedure.

Cervix Uteri↗
PubMedDate not supplied

[Induced labor with prostaglandins in birth weight below 2,500 g].

In a multicenter study the deliveries of 127 newborn infants with a birth weight less than 2500 grams were evaluated after induction of labour using prostaglandins, among them 90 infants with a birth weight below the 10. percentile in relation to the gestational age. The control group were 1566 deliveries of newborns with normal weight, delivered at term after induction with prostaglandins. The rate of vaginal deliveries was 67.6% in the group of newborns weighing less than 2500 grams and 84.1% in the control group. The rate of acidotic newborns (pH < 7.20) was remarkably higher in newborns below 2500 grams (12.6%), especially in the subgroup of growth retarded newborns (16.7%), when compared to the control group (9.5%). In primaiparae with fetal growth retardation and low Bishop score the induction of labour with prostaglandins resulted in an insufficient progress of labour. In this subgroup the rate of cesarean deliveries was 83.3%. Induction of labour was substantially more successful after premature rupture of membranes. The most favourable results were achieved in multiparae after premature rupture of membranes which resulted in vaginal deliveries in 94.5% of cases independent of gestational age.

Administration, Intravaginal↗
PubMedDate not supplied

[Inducing labor with intracervical prostaglandin (PG) gel administration. A comparative analysis of 171 patients with 2 different preparations of PGE2 with regard to course of labor and fetal outcome].

In the present study we examined whether the difference in viscosity of two prostaglandins applied intracervically for induction of labour influences course of labour and fetal outcome. A comparative analysis was carried out in 171 patients, which received either Cerviprost (n = 85) or Prepidil (n = 86) at 6 hour intervals. The results show that the viscosity of the PG E2 has no influence on the course of induction of labour, the mode of delivery or on fetal outcome. The low viscosity does also not present an increased risk for uterine overstimulation, even in case of intracervical application.

Administration, Intravaginal↗
PubMed1993

A randomized trial of extra-amniotic saline infusion plus intracervical Foley catheter balloon versus prostaglandin E2 vaginal gel for ripening the cervix and inducing labor in patients with unfavorable cervices.

OBJECTIVE: To compare the efficacy of extra-amniotic saline solution infusion plus an intracervical Foley catheter balloon versus 2.85 mg prostaglandin (PG) E2 vaginal gel in ripening the cervix, inducing labor, and achieving vaginal delivery in patients at term with an unfavorable cervix. METHODS: A randomized study of the two methods was performed in 112 patients with a Bishop score of 5 or less. RESULTS: Extra-amniotic saline infusion plus intracervical Foley catheter balloon was more effective than PGE2 vaginal gel in causing cervical ripening (relative risk [RR] 2.5965, 95% confidence interval [CI] 1.7277-3.9022, exact two-tailed P = .000001) and in inducing labor (RR 4.3333, 95% CI 1.7223-10.9026, exact two-tailed P = .0000181). However, the final delivery outcome was an equally high number of cesarean deliveries (26 of 56, or 46.4%) for both methods. Maternal and neonatal complications were minimal and not significantly different. CONCLUSIONS: Extra-amniotic saline infusion with a Foley catheter was more effective than 2.85 mg PGE2 vaginal gel in ripening the cervix and inducing labor. These advantages did not translate into a large number of vaginal deliveries, indicating that factors other than cervical ripening may be responsible for the high incidence of cesarean in patients with an unfavorable cervix.

Administration, Intravaginal↗
PubMed2005

Use of mifepristone to ripen the cervix and induce labor in term pregnancies.

OBJECTIVE: This study was undertaken to determine the efficacy of mifepristone for ripening the cervix and inducing labor in term pregnancies. STUDY DESIGN: In a double-blind placebo-controlled dose-finding study, 346 women received 50, 100, 200, 400, or 600 mg of mifepristone or placebo. The main endpoint for efficacy was the number of patients in whom labor occurred between 12 and 45 and 54 hours after treatment or who had a Bishop score 6 or greater. Maternal and fetal tolerability was also studied. RESULTS: No significant efficacy was observed whatever the dose of mifepristone. Mifepristone was well tolerated by the mother and fetus. CONCLUSION: Mifepristone, at doses up to 600 mg, does not induce labor within 54 hours in patients with unfavourable cervical status.

Abortifacient Agents, Steroidal↗
PubMed1999

Differential expression of myometrial oxytocin receptor and prostaglandin H synthase 2, but not estrogen receptor alpha and heat shock protein 90 messenger ribonucleic acid in the gravid horn and nongravid horn in sheep during betamethasone-induced labor.

In the present study, we characterized four myometrial contraction-associated proteins (mCAPs): oxytocin receptor (OTR), prostaglandin H synthase 2 (PGHS2), estrogen receptor alpha (ERalpha), and heat shock protein 90 (Hsp90) messenger RNA (mRNA) expression in the nongravid horn of pregnant sheep and compared them with their expression in the gravid horn that is exposed to a greater degree of stretch. We also examined the regulatory effects of estrogen and progesterone on OTR mRNA expression in ovariectomized nonpregnant sheep. In addition, we determined the ontogeny of mCAP expression in the gravid horn throughout late pregnancy and during spontaneous term labor. Gravid horn and nongravid horn myometria were removed under general anesthesia from control ewes not in labor at 130-140 days gestational age (dGA; n = 3) and during betamethasone-induced labor (n = 6) at the same gestational age. Gravid horn myometrium was also collected from ewes not in labor at 95 dGA (n = 3), 101-110 dGA (n = 3), 111-120 dGA (n = 3), 121-130 dGA (n = 3), 131-140 dGA (n = 3), and 141-145 dGA (n = 4) and from ewes in spontaneous term labor (n = 4). All ewes were carrying single fetuses. Myometrium was also collected from ovariectomized nonpregnant ewes treated with saline (n = 5), estradiol (50 microg/day; n = 5), progesterone (0.3 g, intravaginally; n = 5), and estradiol plus progesterone (n = 5). Myometrial RNA was extracted and analyzed by Northern blot for OTR, PGHS2, ERalpha, and Hsp90 mRNA, normalized for 18S ribosomal RNA or beta-actin. ERalpha, Hsp90, OTR, and PGHS2 mRNA were all significantly up-regulated during betamethasone-induced labor (P < 0.01) in gravid and nongravid horn myometrium. The level of gravid horn OTR mRNA during labor was 3 times the level of nongravid horn OTR mRNA (P < 0.0001). Gravid horn PGHS2 mRNA was also higher than nongravid horn PGHS2 (P < 0.02). In contrast, in spontaneous term labor nongravid horn, ERalpha and Hsp90 mRNA were similar to gravid horn. Myometrial ERalpha and Hsp90 mRNA remained unchanged throughout late pregnancy and increased at spontaneous term labor (P < 0.05). In contrast, myometrial OTR increased around 130 dGA (P < 0.01) and further increased at spontaneous term labor (P < 0.02). Progesterone significantly inhibited myometrial OTR mRNA expression in nonpregnant sheep and estradiol antagonized progesterone's inhibitory effect. Mechanical stretch differentially regulated mCAP mRNA expression in the ovine gravid horn and nongravid horn. Mechanical stretch appears largely responsible for increased OTR mRNA and to a lesser degree PGHS2 mRNA. In addition, endocrine factors may be required for full activation of OTR and PGHS2 mRNA associated with labor. ERalpha and Hsp90 mRNA are not under the control of uterine stretch in keeping with our previous results, indicating that systemic hormones such as estradiol, are prime regulators for these two mCAP mRNA expression during labor.

Animals↗
PubMed1980

[Neuromuscular excitability and duration of labor. Rheobase before and after amniotomy for induced labor].

In 12 primiparae who--on term--did not have spontaneous contractions but a Bishop score greater than 7, Rheobase was measured and there after labour induced by amniotomy. A second evaluation of Rheobase followed one hour after amniotomy. Results show that one hour after rupturing the membranes the Rheobase values decreased significantly (p less than 0,01). The correlation between initial Rheobase values and duration of delivery was still more significant (p approximately 0,001). The possible importance of Rheobase evaluation in the selection of pregnant women on term for elective induction (baby by appointment) is discussed.

Adolescent↗
PubMed1984

Uterine and cardiovascular effects of fenoterol and hexoprenaline in prostaglandin F2 alpha-induced labor in humans.

The effectiveness of the beta-sympathomimetic drugs in prostaglandin-induced labor in humans is uncertain. To assess and compare their uterine and cardiovascular effects, fenoterol (2.5 micrograms/minute) and hexoprenaline (0.38 micrograms/minute) were alternatively infused for 20 minutes in each of 12 patients having prostaglandin F2 alpha inductions of labor at term. Uterine activity was reduced to less than 29% of the pretreatment value. For similar tocolytic effects, hexoprenaline produced a significantly lesser effect on maternal heart rate than fenoterol (P = .005).

Blood Pressure↗
PubMed1980

A comparative study of uterine activity and fetal heart rate pattern in labor induced with oral prostaglandin E2 or oxytocin.

Labor was induced for medical reasons at or near term in altogether 200 patients. The women were randomly assigned to low amniotomy and either oral PGE2 or intravenous infusion of oxytocin. The initial PGE2 dose was 0.5 mg, followed by 1.0 mg every hour for up to 24 hours. Oxytocin was given as an intravenous pump infusion, starting with 5 mIU/min and rising stepwise to 20 mIU/min. Uterine contractility and fetal heart rate (FHR) were recorded by cardiotocography in 61 women receiving oxytocin and in 63 given prostaglandin E2. A detailed analysis of the contractility pattern was performed in 16 women, eight from each group. Labor was established slightly earlier in the oxytocin group than in the prostaglandin group of patients. When in labor, frequency and amplitude of contractions as well as uterine contractility were the same in both treatment groups. The frequency of atypical contractility patterns was higher in labor induced with PGE2 than with oxytocin. One period of hypertonus was observed in one patient treated with PGE2 but it was not associated with alterations in FHR and disappeared without additional therapy. Both mild and more severe variations in FHR occurred but were equally common on both treatment groups. There was no perinatal mortality among the newborns and the Apgar score 5 minutes after delivery was 8 or more.

Administration, Oral↗
PubMed1992

Fetal viability does not affect the onset of stretch-induced labor and the increase in amniotic fluid prostaglandin F2 alpha and plasma prostaglandin F2 alpha metabolite levels.

The role of the fetus in the onset and progress of stretch-induced labor and in the change in amniotic fluid prostaglandin F2 alpha and plasma prostaglandin F2 alpha metabolite levels was evaluated in six normal pregnant women (group 1) and six women whose fetuses had been dead for more than one week (group 2). The uterus was distended by a balloon inflated with physiologic saline. Regular uterine contractions occurred, and increased in all patients. Within 21 hours, all patients delivered a normal baby in group 1 and a macerated fetus in group 2. There was no significant difference in induction-delivery interval between the two groups. Both groups showed a significant and similar range of increases in the levels of amniotic fluid prostaglandin F2 alpha and plasma prostaglandin F2 alpha metabolite during treatment (P less than 0.001). Thus, the fetus has no functional role in the onset and progress of stretch-induced labor or in the rise of amniotic fluid prostaglandin F2 alpha and plasma prostaglandin F2 alpha metabolite levels.

Adult↗
PubMed1978

Inducing labor with oral prostaglandin E2 in Khartoum hospital.

Prostagland-n E2 (PGE2) was administered orally to 109 patients to induce labor. Sixty-five of these patients had an amniotomy prior to PGE2 administration. PGE2 was administered to the remaining. 44, who subsequently underwent amniotomy only after their cervices had reached approximately 6 cm dilation. Labor was successfully induced in 95 patients, but its duration was shorter when amniotomy was immediatedly followed by PGE2 administration. Failed cases were successfully managed with amniotomy and oxytocin infusion. Maternal side effects were minimal. No fetal complications occurred.

Administration, Oral↗
PubMed1978

Inducing labor with oral prostaglandin E2 tablets.

Labor was successfully induced by forewater amniotomy and oral administration of prostaglandin E2 tablets in 91.3% of 153 women with singleton pregnancies. Deliveries occurred within 12 hours for more than 90% of the successfully induced patients. Although not statistically significant, a higher pelvic score appeared to be associated with shorter induction-to-delivery intervals. There were no harmful side effects for either mother or baby; only 14.5% experienced minor side effects, primarily gastrointestinal upsets.

Administration, Oral↗
PubMed1976

The use of oral prostaglandin E2 to induce labor at term.

Prostaglandin E2 (PGE2) was given to 60 patients to induce labor at term. Two dosage schedules were used: 30 patients were given 0.5 mg hourly and 30 patients were given 1.0 mg hourly. Membranes were ruptured when active labor had occurred. The Bishop score was used for inducibility quotient. In general, the higher the Bishop score, the shorter the delivery time. The 1.0 mg dosage schedule decreased the induction time in both nulliparas and multiparas. There were 55 vaginal deliveries. Five patients were delivered by cesarean section for obstetrical indications; two were in active labor. The overall success rate was 91.6%. No fetal distress occurred that could be attributed to the PGE2. Maternal complications consisted of nausea and vomiting.

Administration, Oral↗
PubMed1988

Oxytocin-induced labor characteristics and uterine activity after preinduction cervical priming with prostaglandin E2 intracervical gel.

Labor characteristics and quantitation of uterine activity resulting from oxytocin induction of labor after intracervical prostaglandin E2 (PGE2) gel priming have not been previously reported. Forty-seven women with modified Bishop scores of 5 or less received preinduction priming with 0.5 mg of intracervical PGE2 gel. Oxytocin was used to induce labor after priming, and uterine activity was quantitated. A matched group of control patients was managed identically but did not receive PGE2 gel. In the gel group, modified Bishop scores improved significantly and in two patients (4%), priming alone induced labor. No uterine hyperstimulation or fetal heart rate abnormalities occurred during priming. Cesarean sections for all indications and those for failed induction were less common in the gel group. The length of the active phase and the second stage of labor were significantly shorter in the gel group. Uterine activity was similar in both groups. The data suggest a primary cervical action of the gel.

Adult↗