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العنوان
Is the risk of emergency cesarean delivery in nulliparous women differing from multiparous after induction of labor?/
المؤلف
El-Shayb,Zein Ibrahim Ibrahim
هيئة الاعداد
باحث / زين إبراهيم إبراهيم الشايب
مشرف / حــازم الزنيني
مشرف / هيام فتحي محمد
تاريخ النشر
2015.
عدد الصفحات
11.p;
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
أمراض النساء والتوليد
تاريخ الإجازة
1/10/2015
مكان الإجازة
جامعة عين شمس - كلية الطب - Obstetrics & Gynecology
الفهرس
Only 14 pages are availabe for public view

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Abstract

I
nduction of labor should be used in the most efficient way possible that will result in a favourable obstetric outcome with minimum fetal morbidity because of the limited resources available. So, induction of labor in post term pregnant women was evaluated in this study with prostaglandins which has become an intensely investigated topic. Dinoprostone is an effective agent for cervical ripening and labor induction for mothers with viable pregnancies. It is one of the most common prostaglandins analogues currently used as cervical ripening and labor inducing agents.
The study was carried out at the labor ward of the department of Obstetrics & Gynecology at Ain Shams Maternity University Hospital starting on 1st of May 2012.
The aim of this work to assess the risk for emergency cesarean section between nulliparous and multiparous women who will undergo induction of labor in gestational weeks ≥ 41 and to evaluate if parity and Bishop score affected this association.
All patients were subjected to full history taking, full clinical examination (general, abdominal and local examinations), investigations (U/S scan and admission CTG).
The 150 pregnant women were allocated to one of two equal groups each consists of 75 women, group (A) for nulliparous women, group (B) for multiparous women.
Women with Bishop score < 5 will undergo cervical ripening by dinoglandin (prostaglandin E2 (PGE2), vaginal Suppository each suppository contains 3 mg of dinoprostone inserted in the posterior vaginal fornix and to be repeated up to two doses each every 6 hours under continuous fetal monitoring.
Failure of induction was considered after 2 doses of induction were given and failed to achieve uterine contractions & cervical changes.
Women with Bishop score > 5 will be induced by stripping of membranes, aminiotomy and oxytocin infusion then monitoring progress of labor up to delivery by partogram and fetal monitoring by cardiotocogram (CTG).
Two groups show only parity proved to be associated with emergency CS. nullipara were at a higher risk for emergency CS than multipara.
There was a higher proportion of vaginal delivery in both groups (66.7% of nullipara) and (81.3% of multipara).
There was a higher proportion of induction of labor by dinoglandin in both groups (90.7% of nullipara) and (82.7% of multipara).
The most common causes of cesarean section in both groups are thick meconium (40% of primigravida, 42.9% of multigravida) and failure of progress (36% of primigravida, 28.6% of multigravida).
There is no statistically significant difference between vaginal delivery and emergency CS regarding method of induction.
Bishop score in vaginal delivery (Mean is 3.72 and SD is 1.39), in emergency CS (Mean is 3.33 and SD is 1.01) is statistically non significant (P>0.05) as most cases of emergency CS was due to fetal distress.