A COMPARATIVE STUDY OF EXTRA – AMNIOTIC SALINE INFUSION AND HIGH DOSE OXYTOCIN WITH PROSTAGLANDIN E2 SUPPOSITORY AND HIGH DOSE OXYTOCIN IN PRE - INDUCTION CERVICAL RIPENING IN SECOND TRIMESTER PREGNANCIES.

Amirabi, A and Salarilak, S and Golmohammad Lou, S and Khabiry, L (2009) A COMPARATIVE STUDY OF EXTRA – AMNIOTIC SALINE INFUSION AND HIGH DOSE OXYTOCIN WITH PROSTAGLANDIN E2 SUPPOSITORY AND HIGH DOSE OXYTOCIN IN PRE - INDUCTION CERVICAL RIPENING IN SECOND TRIMESTER PREGNANCIES. J Urmia Univ Med Sci., 19 (4). pp. 295-301.

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Abstract

It is necessary to terminate pregnancy for fetal or maternal indications in some second trimester pregnancies. The cervix is usually unripe in 2nd trimester, so pre-induction ripening is mandatory. The aim of this study is to compare the efficacy of extra-amniotic saline infusion with prostaglandin E2 suppository in pre-induction cervical ripening in 2nd trimester pregnancies. Materials & Methods: In this study, women (n= 80) with indications of termination of pregnancy (range 14-28 weeks) and bishop scores of 3 and lower were assigned randomly to receive extra-amniotic saline infusion (2ML/ min) or prostaglandin suppository (6mg).We induced uterine contractions using intravenous oxytocin only when contractions had not commenced by 6 hours after extra-amniotic saline infusion and 4 hours after prostaglandin. We assessed ripening efficacy, success and failure of therapy, mean time of induction, and complications of two methods. Statistical analysis was done based on the data. Results: The mean pre-ripening bishop score was l.2±0.53 in group 1 (extra-amniotic saline infusion) and 1.68±0.66 in group 2 (prostaglandin). The mean post- ripening BSC was 4.5±2.14 in group I and 3 ± 1.6 in group 2, which was significant. There were 20 (%50) fetus expulsion in group 1 and 8 (20%) in group 2. The mean time for induction was 17.27 ± 8.38 hours in group 1 and 20.9 ±6.17 hours in group 2, which was statistically significant. One patient in group 1 had vaginal bleeding because of warfarin use. Three patients had nausea in group 2. There were no other complications in both methods. Conclusion: Cervical ripening by extra-amniotic saline infusion is faster and more effective than 6 mg prostaglandin E2 suppository, resulting in a higher rate of fetus expulsion in 2nd trimester.

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