A Randomized Control Trial Of Extra-Amniotic Saline Infusion (Easi) Versus Intracervical Dinoprostone Gel For Induction Of Labour

Abstract

Background and objectives Success of induction depends largely on cervical ripening and increases the likelihood of vaginal delivery. This study compared the outcomes of induction for labour using extra amniotic saline infusion versus intracervical dinoprostone gel. Methodology A randomized controlled trial of one year was conducted in the Department of Obstetrics and Gynaecology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi on 82 pregnant womenfrom January 2014 to December 2014. The selected women were divided into two groups of 41 each as Group A (Dinoprostone) and Group B (EASI). These women were evaluated for improvement between pre and post induction Bishop’s scores, induction to delivery interval, mode of delivery and neonatal outcome. Results The mean age in group A (22.27 ± 3.11 years) and group B (22.54 ± 2.88 years) was comparable (p=0.687). The demographic characteristics, obstetric history, indications for induction and pre-induction Bishop’s scores were comparable in group A and B (p>0.050). Significantly higher number of women had post induction Bishop’s scores between 9 to 12 in group A (70.73%) (p<0.001) and the mean Bishop’s scores in group A were significantly high (9.27±3.07 vs 8.22±2.34; p=0.086). Cervical ripening based on cut-off score of ≥6 was noted in significantly higher number of women (92.68%) in group B (p=0.241). The mean time for cervical ripening was significantly high in group A compared to group B (15.44±8.41 vs 3.88±3.67;p<0.001) but mean induction to delivery time was comparable (p=0.086). Significantly higher numbers of vaginal deliveries were noted in groupA (91.43%) (p=0.001).The neonatal outcome that is, birth weight, mean birth weight, apgar score at one and five minutes, and NICU admission were comparable (p=0.570). Conclusion and interpretation EASI using Foley’s catheter and dinoprostone gel appear to be effective methods for cervical ripening and labour induction but dinoprostone gel yielded significantly higher rate of vaginal delivery.