Search

Objectives: The aim of the study was to evaluate whether the presence of the disease in pregnancy influences the effectiveness and safety of delivery preinduction with prostaglandins: misoprostol vaginal insert and dinoprostone vaginal gel., Material and Methods: This is aretrospective cohort study conducted of 560 pregnant women. The concomitant diseases mainly recorded were diabetes mellitus, hypertensive diseases, intrahepatic cholestasis of pregnancy, asthma, thrombocytopenia, and hypothyroidism. The primary study outcome was a successful vaginal delivery. The study above others evaluates the time from treatment implementation to the beginning of a labor and to a final delivery, the rate of Cesarean sections, and the presence of delivery complications., Results: Among women with a concomitant disease, Caesarean section was observed more frequently in the misoprostol group. In the dinoprostone group, mothers with the concomitant disease as compared to healthy mothers required more time to the delivery and to achieve the beginning of labor. There were no differences in postpartum complications regardless of the prostaglandins, comorbidities or mothers' age. Neonates of mothers ≥ 35 years old with concomitant disease had lower average Apgar scores., Conclusions: Our study showed that comorbidities seem to increase the caesarean section risk in the misoprostol preinduction group but in the dinoprostone group they prolong the time needed to achieve an active labour phase and a delivery.

Objectives: Induction of labour is a part of an active prenatal care nowadays and the ideal method of that procedure still remains to be identified. The purpose of this study was to evaluate effectiveness of misoprostol vaginal insert as compared to dinoprostone gel for delivery induction in pregnant women without any comorbidities., Material and Methods: It was a retrospective cohort study of 240 pregnant women. The primary study outcome was successful delivery. Other analysed parameters included time to delivery of a baby, time to the beginning of the first stage of labour, time to vaginal delivery, and duration of all delivery stages. We compared both methods regarding maternal complications during and after delivery. We also reviewed neonatal outcomes such as birth weight, birth length and 1-minute Apgar scores., Results: The patients' basic characteristics were similar regarding their age, gravidity, parity, height, weight and Bishop score. Time to any delivery and to the onset of a labour in the misoprostol group versus in the dinoprostone group was 14.5 vs 35.6 h (p < 0.001) and 9.9 h vs 25.3 h (p < 0.001) respectively. The chance of the beginning of labour and the baby's delivery over time has been observed to be approximately two times higher for misoprostol as compared to dinoprostone., Conclusions: Our study showed that using misoprostol vaginal insert in comparison to dinoprostone seems to shorten the time to beginning of the first stage of labour as well as the time to the delivery itself. Some lower Apgar scores observed in the misoprostol group requires further investigation.

Background: Hypertension is one of the most frequent complications of pregnancy. Due to high risk of morbidity and mortality in both mothers and children, it is necessary to continuously monitor the pregnancy, principally with biophysical methods. Particularly, doppler velocimetry of the materno-fetal circulation proves useful. THE AIM of the study was to assess the usefulness of doppler test in monitoring the condition of the foetus in preterm delivered pregnancy complicated with hypertension., Material and Methods: The retrospective analysis comprised the data of 116 women who delivered prematurely at the Clinics of the Department of Gynaecology and Obstetrics at the Collegium Medicum of the Jagiellonian University in the years 2006-2007, resulting in creation of Group I involving 38 pregnant women with preeclampsia, and Group II of 36 women whose pregnancy was complicated with gestational hypertension. Control group was formed of 42 women with correct arterial blood pressure. When describing the groups, the differences in the birth weight and Apgar score were indicated., Results: A significant statistical difference was found in the area of pulsation rate in the umbilical artery and cerebro-placental ratio (CPR). In the case of preterm delivery complicated with arterial pressure disorders, the foetus is characterised with worse organic perfusion and slower somatic growth than if no concomitant hypertension is present. Hypertension forms an additional risk factor in the course of preterm delivery, and doppler velocimetry is a good method for monitoring the condition of the foetus, as it allows for detection of irregularities and for implementation of relevant treatment to improve the newborn's condition at birth.