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.

References

Миляева Н.М., Ковалев В.В. Преиндукция и индукция родов. Теоретические и практические аспекты : методические рекомендации для врачей. – Екат.: ГБОУ ВПО «Уральский гос. мед. унив-т», 2016 [Milyaeva N.M., Kovalev V.V. Preindukciya i indukciya rodov. Teoreticheskie i prakticheskie aspekty : metodicheskie rekomendacii dlya vrachej. – Ekat.: GBOU VPO «Ural'skij gos. med. univ-t», 2016 (in Russ.)]. https://core.ac.uk/download/pdf/198200968.pdf

Атабиева Д.А., Чилова Р.А., Гадаева И.В., Ковалев М.И., Пикуза Т.В., Однокопытный А.В., Жолобова М.Н., Каптильный В.А. Прогностические значение методов оценки состояния матери и плода. – 2015. – Т. 2, №2. – С. 4-10 [Atabieva D.A., Chilova R.A., Gadaeva I.V., Kovalev M.I., Pikuza T.V., Odnokopytnyj A.V., Zholobova M.N., Kaptil'nyj V.A. Prognosticheskie znachenie metodov ocenki sostoyaniya materi i ploda. – 2015. – T. 2, №2. – S. 4-10 (in Russ.)]. https://www.elibrary.ru/item.asp?id=23923549

Демченко О.Б. Когда индукция родов в акушерстве – это современная, безопасная, эффективная и надежная стратегия // Акушерство, Гінекологія, Репродуктологія. – 2018. – №4(32). – С. 38-41 [Demchenko O.B. Kogda indukcija rodov v akusherstve – jeto sovremennaja, bezopasnaja, jeffektivnaja i nadezhnaja strategija // Akusherstvo, Gіnekologіja, Reproduktologіja. – 2018. – №4(32). – S. 38-41. (in Russ.)]. https://health-ua.com/article/40617-kogda-induktciya-rodov-vakusherstveeto-sovremennaya-bezopasnaya-effektivnay

Баев О.Р., Баранов И.И. Индукция родов в сроке 41 неделя или выжидательное ведение до 42 недель: данные обсервационных, рандомизированных исследований, систематических обзоров и метаанализа // Акушерство и гинекология: Новости. Мнения. Обучение. – 2021. – №9(2). – С. 19-33 [Baev O.R., Baranov I.I. Indukcija rodov v sroke 41 nedelja ili vyzhidatel'noe vedenie do 42 nedel': dannye observacionnyh, randomizirovannyh issledovanij, sistematicheskih obzorov i metaanaliza // Akusherstvo i ginekologija: Novosti. Mnenija. Obuchenie. – 2021. – №9(2). – S. 19-33 (in Russ.)]. https://doi.org/10.33029/2303-9698-2021-9-2-19-33

Бабич Д.А. Прогнозирование исхода индукции родов с учетом оценки ультразвуковых параметров и эластографии шейки матки // Автореф. дисс. … канд. мед. наук: 14.01.01, 14.01.13. – М.: ФГАОУ ВО Первый МГМУ имени И.М. Сеченова МЗ РФ, 2021. – 26 с. [Babich D.A. Prognozirovanie isxoda indukcii rodov s uchetom ocenki ul'trazvukovyx parametrov i e'lastografii shejki matki // Avtoref. diss. … kand. med. nauk: 14.01.01, 14.01.13. – M.: FGAOU VO Pervyj MGMU imeni I.M. Sechenova MZ RF, 2021. – 26 s. (in Russ.)]. https://www.sechenov.ru/upload/iblock/603/Avtoreferat-Babich-D.A..pdf

Наумов А.Д., Подгурская К.В., Кришталь В.С., Косинец М.В. Сравнительный анализ способов подготовки шейки матки к родам и исход родов // Молодой ученый. – 2016. – №10. – С. 517-521 [Naumov A.D., Podgurskaja K.V., Krishtal' V.S., Kosinec M.V. Sravnitel'nyj analiz sposobov podgotovki shejki matki k rodam i ishod rodov // Molodoj uchenyj. – 2016. – №10. – S. 517-521. (in Russ.)]. https://cyberleninka.ru/article/n/sravnitelnyy-analiz-sposobov-podgotovki-sheyki-matki-k-rodam-i-ishod-rodov-1

Grobman W.A., Rice M.M., Reddy U.M., Tita A.T.N., Silver R.M., Mallett G., Hill K., Thom E.A., El-Sayed Y.Y., Perez-Delboy A., Rouse D.J., Saade G.R., Boggess K.A., Chauhan S.P., Iams J.D., Chien E.K., Casey B.M., Gibbs R.S., Srinivas S.K., Swamy G.K., Simhan H.N., Macones G.A.; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Labor Induction versus Expectant Management in Low-Risk Nulliparous Women // N. Engl. J. Med. – 2018. – Vol. 379(6). – P. 513-523. https://doi.org/10.1056/NEJMoa1800566

Российское общество акушеров-гинекологов. Роды одноплодные, родоразрешение путем кесарева сечения. Клинические рекомендации. – 2021. – 106 c. [Rossijskoe obshhestvo akusherov-ginekologov. Rody odnoplodnye, rodorazreshenie putem kesareva sechenija. Klinicheskie rekomendacii. – 2021. – 106 s. (in Russ.)]. http://minzdravrm.ru/wp-content/uploads/2021/07/Rodi_odnoplodtii_rodorazrechenie_putem_kesareva.pdf

Алтаева А.А., Исенова С.Ш., Эгле М. Внедрение классификации Робсон В Республике Казахстан для снижения частоты кесарева сечения // Вестник КазНМУ. – 2019. – №3. – С. 15-21 [Altaeva A.A., Isenova S.Sh., Jegle M. Vnedrenie klassifikacii Robson V Respublike Kazahstan dlja snizhenija chastoty kesareva sechenija // Vestnik KazNMU. – 2019. – №3. – S. 15-21 (in Russ.)]. https://cyberleninka.ru/article/n/vnedrenie-klassifikatsii-robson-v-respublike-kazahstan-dlya-snizheniya-chastoty-kesareva-secheniya

Лопатин А.М., Костин И.Н., Кузнецова О.А., Смирнова Т.В. Индукция или ожидание? // Акушерство и гинекология: Новости. Мнения. Обучение. – 2018. – Т. 6, №3. – Приложение. – С. 92-95 [Lopatin A.M., Kostin I.N., Kuznecova O.A., Smirnova T.V. Indukcija ili ozhidanie? // Akusherstvo i ginekologija: Novosti. Mnenija. Obuchenie. – 2018. – T. 6, №3. – Prilozhenie. – S. 92-95 (in Russ.)]. https://doi.org/10.24411/2303-9698-2018-13913

Middleton P., Shepherd E., Morris J., Crowther C., Gomersall J. Induction of labour at or beyond 37 weeks' gestation // Cochrane Database Syst. Rev. – 2020. – Issue 7. – Art. No.: CD004945. https://doi.org/10.1002/14651858.CD004945.pub5

Middleton P., Shepherd E., Crowther C.A. Induction of labour for improving birth outcomes for women at or beyond term // Cochrane Database Syst. Rev. – 2018. – Issue 5. – Art. No.: CD004945. https://doi.org/10.1002/14651858.CD004945.pub4

Радзинский В.Е., Доронина О.К., Старцева Н.М., Исенова С.Ш., Исина Г.М., Бищекова Б.Н., Абдыкалыкова Б.И. Индукция родов мифепристоном и цервикальным баллонным катетером // Вестник КазНМУ. – 2022. – №2. – С. 103-115 [Radzinskij V.E., Doronina O.K., Starceva N.M., Isenova S.Sh., Isina G.M., Bishhekova B.N., Abdykalykova B.I. Indukcija rodov mifepristonom i cervikal'nym ballonnym kateterom // Vestnik KazNMU. – 2022. – №2. – S. 103-115 (in Russ.)]. https://kaznmu.edu.kz/press/wp-content/uploads/2022/09/ВЕСТНИК-КазНМУ-№2-2022.pdf

Anh N.D., Duc T.A., Ha N.T., Giang D.T., Dat D.T., Thuong P.H., Toan N.K., Duc N.T., Duc N.M. Dinoprostone Vaginal Insert for Induction of Labor in Women with Low-Risk Pregnancies: A Prospective Study // Med. Arch. (Sarajevo, Bosnia and Herzegovina). – 2022. – Vol. 76(1). – P. 39-44. https://doi.org/10.5455/medarh.2022.76.39-44

Доронина О.К. Индукция родов при доношенной беременности. Цервидил -вагинальная терапевтическая система с динопростоном // Акушерство и гинекология: Новости. Мнения. Обучение. – 2021. – Т. 9, № 3 (33). – С. 46-51 [Doronina O.K. Indukciya rodov pri donoshennoj beremennosti. Cervidil -vaginal'naya terapevticheskaya sistema s dinoprostonom // Akusherstvo i ginekologiya. Novosti. Mneniya. Obuchenie. – 2021. – T. 9, № 3 (33). – S. 46-51 (in Russ.)]. http://elibrary.ru/item.asp?id=46498056

Downloads

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. 2 (55) (May 2023), 31–38. DOI:https://doi.org/10.37800/RM.2.2023.31-38.

Issue

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

Section

Статьи

License

The articles published in this Journal are licensed under the CC BY-NC-ND 4.0 (Creative Commons Attribution – Non-Commercial – No Derivatives 4.0 International) license, which provides for their non-commercial use only. Under this license, users have the right to copy and distribute the material in copyright but are not permitted to modify or use it for commercial purposes. Full details on the licensing are available at https://creativecommons.org/licenses/by-nc-nd/4.0/.