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terine acti8it0 infl.s.ence the acid base stat.%0 6. )abor is a stress factor for the fet.s onset leadin7 to 4ro7ressi8e effacement and dilatation of cer8i9 and deli8er0 of the bab0.1 %nd. VYDEHI INSTITUTE OF MEDICAL SCIENCES AND RESEARCH CENTRE BANGALORE .% !"' )!*.tion / 2 3 (o.s initiation of .s of the fet.( !"' &-!'-.BHIMA HARIKA DEPARTMENT OF OB ! "#DE$% %N&T%T'TE OF MED%(A) &(%EN(E& * RE&EAR($ (ENTRE! +$%TEF%E)D ! BAN A)ORE.d0 and s. B%&'( %')*+' . (.RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BENGALURU. D.rin7 acti8e labor the inte7rit0 of the .enc0 and intensit0 of .rse MAY.'.rse of the st.66 MS (OBSTETRICS AND GYNAECOLOGY) 2 !" - Name of the %nstit. 2#$2 Title of to4ic5 RANDOMISED COMPARATIVE CLINICAL STUDY OF THE EFFICACY AND SAFETY OF INTRACERVICAL PROSTAGLANDIN E2 WITH INTRAVAGINAL PROSTAGLANDIN E$ IN INDUCTION OF LABOR AND ITS OBSTETRICS OUTCOME. /.b1ect Date of admission to co.lation and the fre:.s 6 .tero4lacental circ.terine contractions! 4rior to their s4ontaneo. KARNATAKA PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION 1 Name of the candidate and address (in block letters) DR.$ N''.ction of labor is the nons4ontaneo.

ere less fre:.irement .ld be deli8ered in a 7ood condition .7 administered 6hrl0 a44ears to be most effecti8e as it has least .lar means to soften and dilate the cer8i9/. (linical o. $alf of them .m maternal side effects.nfa8orable cer8i9 a to4icall0 a44lied 4rosta7landin! containin7 either 4rosta7landin E.ded that -3.ction cer8ical ri4enin7 at term and concl.4erior in 4romotin7 cer8ical ri4enin7! si7nificantl0 shortened the re:.ith close monitorin72. st.m im4ro8ement in Bisho4 score! least o90tocin re:..ction to deli8er0 inter8al .4s6.&a9ena et al stated that intra8a7inal miso4rostol 3=. Fetal heart rate monitorin7 is sensiti8e s.ction.ce caesarian section. 6. The neonate sho.d0 is to com4are efficac0 and safet0 of 4rosta7landinE1 and 4rosta7landin E.ill ha8e an .7 miso4rostol! more o8er miso4rostol is chea4er ! easier to store and stable at room tem4erat.2 R'2&'/ .d0.rl0 -3. The aim of! hence the need for the st. %n -=11! P.t an0 increase in com4lication rate3.rred after lon7er ind.dies ha8e been done .hen a44lied in the hos4ital settin7 . 13<of 4re7nant .tcomes . %n -==?! @ & @rithika et al stated that intra8a7inal miso4rostol -3.ith 6 th ho.ent and occ.ith minim.hich is reflected in the fetal heart tracin7s on cardiotoco7ra4h 1.ction of labor to achie8e 8a7inal deli8er0 and red.( 3&!'%4!*%'5 %n -=1-! N & (hitrakar com4ared miso4rostol 8ers. %n -=11! )eo Pe8>ner et al concl.fficient to dia7nose fetal as4h09ia before 4ermanent brain dama7e occ.itho.hen com4ared to intracer8ical .ith shorter ind.ded that cardiotoco7ra4hic abnormalities .or 4rosta7landin E1 is the most 4o4. %t is safe and effecti8e for cer8ical ri4enin7 .7 2hrl0 is safe and effecti8e for ind.7 dose of miso4rostol is s.s dina4rostone for 4reind. Fe.ere similar amon7 the 7ro.ction of labor .ction to deli8er0 inter8al time! has ma9im.ction deli8er0 inter8al.ire aid in cer8ical ri4enin7 and labor ind.ith M"%3= than M"%1== or dina4rostone. effecti8e and ine94ensi8e in the miso4rostol 7o.ith si7nificantl0 shorter! fetal distress . : M4!'%&43) 4-.d0 on (T abnormalities associated .( !"' )!*.ded that miso4rostol is more efficacio.lation s0ndrome?.ction of labor C mode of deli8er0.ction of labor .ith that of combination of dino4rostone and o90tocin for ind.s dino4rostone cer8ical 7el for cer8ical ri4enin7 and labor ind.cer8i4rimeA.-5 Randomi>ed com4arati8e clinical trial 1== 4re7nant .e>li + et al com4ared efficac0 and safet0 of intra8a7inal miso4rostol 8ers.ction deli8er0 inter8al .4!4 S!*.ith dino4rostone and miso4rostol cer8ical ri4enin7 ha8e concl.ded that miso4rostol is more effecti8e than dino4rostone 7el a44lication.ction and concl.6 O78'9!&2') .ar0 -=1/ to D.$ S.( . There is si7nificantl0 increased incidence of abnormal F$R tracin7s and the trend in increased cesarean deli8eries for fetal distress .')&.s than dino4rostone for labor ind. %n -==3! Ramse0 P& et al in their st.rth0 et al com4ared efficac0 ! safet0! cost and fetal o.ded that ind.1 .rth0 Bhaskar @rishnam.tcome of ind.ction of labor and concl. There is tendenc0 for an increase in the rate of tach0s0stole and h04erstim.. %n -==A! Den7.ction deli8er0 inter8al /) To com4are o.te of Medical &ciences from Dan.ction. %n -==6! M.ith miso4rostol1=. -=12.ith intra8a7inal 4rosta7landin E1 and intracer8ical 4rosta7landinE-) To com4are ind.omen admitted for safe confinement in the de4artment of Obstetrics and 0necolo70! "0dehi %nstit.) common! cost of thera40 .s maternal and fetal risk factors . M'!".1 1) To com4are the 8ario.tcome of miso4rostol .*%9' . .

. • Pro7ress! total d.2 M'!". • Assessment of the bab0 .7mentation if needed. <%.d0 consists ofE • Detailed histor0 . • (ardiotoco7ra4h in acti8e labor.ntil dischar7e.terine contractions of 7reater than / contractions in 1=min .4t.ith intra8a7inal 4rosta7landin E1 and 3= .ith intracer8ical 4rosta7landinE-.ill be ind.r assessed .4!4 (&-93*.( of membranes done in acti8e labo.ced .ced . • Patients . • Non &tress Test as an admission test.omen not in labor The method of st.33'9!&.ith established .ith intra8a7inal 4rosta7landin E1 -3. :.7 6hrs a4art to ma9im.15 4re7nant .r..ith e9amination.( .sion criteria5 a) ante4art. • Bisho4 score assessment.sion criteria5 a) sin7leton li8e 4re7nanc0 b) ce4halic 4resentation c) intact membranes d) 4atient . )4+<3&-.ed .&-.ration of labo. %ncl.ill be recorded and the neonate follo.m of 3 doses and intracer8ical 4rosta7landin E=.*%' &( 4-1) D'(&-&!&.3= .ill not be reEdosed.m haemorrha7e b) ce4halo4el8ic dis4ro4ortion .sin7 4arto7ram.m of /doses alternatel0. • O90tocin a.. • %nd.4 ..ction E9cl..ction .ith an indication for ind.9'.( 4 )*78'9! )!*. .3m7 6hrs a4art to ma9im. • Mode of deli8er0.ill be ind. • Artificial r.sin7 AP AR score • %n8esti7ations done and the treatment 7i8en .

% 4-&+43> I( ). .6 #es .s . S!4!&)!&943 4-431)&)5 Data .m cardiotoco7ra4hic tracin7.6 D.ins 7rand m. :.dent t test. • Artificial r.*% &-)!&!*!&..c) d) e) f) 7) h) i) 1) 4re7nanc0 .-.ith con7enital malformations intra.*9!'. 7' These in8esti7ations .. #es! the 4resent st.( :.% &-!'%2'-!&.coma 4atients .4t.ction bronchial asthma! 7la.<4!&'-!) .7!4&-'.-) . :..ill be anal0sed .!"'% "*+4-) .r( if membranes are not s4ontaneo.94)' .% .sl0 r.ill be cond. <3'4)' .d0 re:.4!&.terine scar abnormal fetal heart rate 4attern before ind.? H4) '!"&943 93'4%4-9' 7''.+ 1.are test! fisher e9act test! st.')9%&7' 7%&'(31.4t.&.') !"' )!*.-) !.lti4ara mal4resentations 4re8io.terine death of membranes done in acti8e labo.1 %'=*&%' 4-1 &-2')!&.cted once an informed consent is taken from the 4atient..ires the follo.in7 s4ecific in8esti7ations and inter8entions5 • %ntra4art. (%.sin7 chiE s:.


for ind. E. E. Do. P. =AG-=11F13(A)5A3BE6/.Ba1a1! A. Adamsons @.r8 -==. Me7alo A! Peti7nat P! $ohlfeld P. Obstet 0necol s. Preind. efficac0 and safet0 of si9 ho. Do.r D Obstet 0necol Re4rod Biol -==2 F 116 (1)5 /2E/?.+in75 (ardiotoco7ra4hic abnormalities associated .ncil =1G-=1-F1=(1) -=11.rn +F. 2. )eo 4e8>ner! Harko Alfire8ic! Barbara ). /. infl.rl0 8a7inal .ence of miso4rostol or 4rosta7landin E.&a9ena! M.ction of labor on the incidence of 4atholo7ical (T tracin75 a randomi>ed trial.ction of labor .hi M.rnal of Obstetrics and 0naecolo705 the 1o.e -! 4a7es 122E12?! D. (DO%51=.nfa8o.s dino4rostone for 4reind.ro4ean re8ie. Ra0b.ction.ction cer8ical ri4enin75 basis and methods of c. E. M0ers Re.ith miso4rostol and dino4rostone cer8ical ri4enin7 and labor ind.cti8e Biolo70 8ol. N & (hitrakar.ction.R'('%'-9') 1.rnal of the instit.P.ro4ean 1o. )ate decelerations and brain tolerance of the fetal monke0 to intra4art.e>li +! Trimech A! $addad A! $a11a1i A! &aidani H! Faleh R! &ako.ri5 Pros4ecti8e randomi>ed controlled trial to com4are safet0 and efficac0 of intra8a7inal miso4rostol .) ?.Mishra! && Tri8edi5 A randomi>ed clinical trial to com4are the efficac0 of different doses of intra8a7inal miso4rostol . 3. (om4arison of miso4rostol 8ers. Am D Obstet 0neco 1BBA F 1-?5 ?B/.ith intracer8ical dino4rostone for cer8ical ri4enin7 and labor ind.ction cer8ical ri4enin7 at term.rnal of Ne4al health research co. =3G-==?F -?(/)5-B2EBA.ri! 136! iss.1=2).rnal of Obstetrics * 0naecolo70 and Re4rod.! "s.rable cer8i9.te of Obstetrics and 0naecolo70 (im4act factor5=.rrent 4ractice.ith . 6. A. 1=?=G=122/61=?=-=32BA.ith intracer8ical cer8i4rime for ind. @& @rithika! N A7ar.octF 3A (1=)56?/EB-. for medical and 4harmacolo7ical sciences (im4act factor.m as4h09ia. -.2/).ers! Deborah A.

@ S&.-4!*%' ..$ G*&.' DR.-4!*%' $$. $$ N4+' 4-.( !"' D'<4%!+'-! DR .90 3'!!'%)) $$.6 H'4.4!' $# R'+4%0) . $$.$ R'+4%0) .( !"' 94-.' The st.73.? S&. .d0 is si7nificant as miso4rostol is cost effecti8e and easier to administer.*&.2 S&.')&.( !"' C"4&%+4.A P%&-9&<43 $2.*&..-4!*%' $2 $2.( !"' .( !"' .' (&.2 S&. $$.SREEDHAR VENKATESH Professor and $ead of the De4artment! De4artment of OB ! "#DE$% %N&T%T'TE OF MED%(A) &(%EN(E& AND RE&EAR($ (ENTRE!+$%TEF%E)D! BAN A)ORE.-4!*%' .&.-4!&. .SAMPATH KUMAR Professor De4artment of OB ! "#DE$% %N&T%T'TE OF MED%(A) &(%EN(E& AND RE&EAR($ (ENTRE!+$%TEF%E)D! BAN A)ORE.