The effectiveness of pre-induction on the outcome of pregnancy and the influence on the condition of the newborn

Authors

  • B.N. Bishekova
  • T.A. Kozhabekova
  • S.B. Rakhimova
  • N.A. Tleukul Казахский национальный медицинский университет им. С.Д. Асфендиярова
  • A.E. Rakhimov

DOI:

https://doi.org/10.37800/RM.2.2023.31-38

Keywords:

pregnancy, pre-induction, induction, prostaglandin, misoprostol, childbirth, newborn

Abstract

Relevance: In recent years, there has been an increase in the frequency of labor induction, in developed countries it is 25% of the total number of full-term births and 20-30% of premature pregnancies. Timely and correct assessment of the state of readiness ("maturity") of the cervix for childbirth is of great importance in determining the prognosis of the course of upcoming labor and especially in clarifying the indications and timing for induction of labor.

The purpose of this study is to evaluate the effectiveness of cervical preparation on the outcome of pregnancy and the effect on the condition of the newborn.

       Methods: The prospective study presents the results of a survey of 160 pregnant women admitted to the city maternity hospital No. 5 in Almaty in 2021, delivered by pre-induction /induction of labor. The main group consisted of pregnant women who used misoprostol orally (n=110), the comparison group consisted of women who were injected with gel–dinoproston vaginally (n=50).

Results: The main indications for induction of labor were: a tendency to overgrowth (49.1% vs. 42.0% p=0.05), hypertensive conditions (22.7% vs. 24.0% p= 0.05), fetal growth retardation (14.6% against 16.0% p=0.05) and lack of water – 13.6% vs. 18.0% p=0.05). The average dose of misoprostol in primiparous was 125-150 mcg, in repeat births 100-125 mcg. Dinoproston gel (1 mg) was injected into the posterior vaginal arch. If necessary, a second dose of gel was administered after 6 hours: 1-2 mg.

      Against the background of taking medications, regular labor activity developed in 81.8% vs. 80% (p=0.05), spontaneous labor occurred in 88.2% vs. 90.0% (p=0.05) women in labor. Operative delivery (cesarean section, vacuum fetal extraction) was performed in 11.8% vs. 10.0% (p=0.05) cases. The prevailing number of newborns was assessed on the Apgar scale by 8 points, only 7.2% of newborns in the main group and 6.0% of the comparison group were born in a state of mild and moderate asphyxia.

Conclusion: Thus, timely preparation of the cervix for childbirth by oral administration of misoprostol (prostaglandin E1) and dinoprostone (Prostaglandin E2) are effective methods of pre-induction of labor that do not affect the frequency of cesarean section and do not adversely affect the condition of the newborn. The practical significance of this study will allow the implementation of this method in practice, in accordance with the current protocols of diagnosis and treatment.

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Published

2023-05-29

How to Cite

[1]
Bishekova Б. , Kozhabekova Т. , Rakhimova С. , Tleukul Н. and Rakhimov А. 2023. The effectiveness of pre-induction on the outcome of pregnancy and the influence on the condition of the newborn. Reproductive Medicine (Central Asia). 2 (55) (May 2023), 31–38. DOI:https://doi.org/10.37800/RM.2.2023.31-38.

Issue

No. 2 (55) (2023): Reproductive medicine

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Статьи

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