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Year : 2014  |  Volume : 28  |  Issue : 1  |  Page : 29-33

Induction of labor in patients with previous cesarean section with unfavorable cervix

1 Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur, India
2 Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Dr. Laishram Trinity Meetei
Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal - 795 004, Manipur
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-4958.135223

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Background and Objective: Due to increased risk of uterine rupture with prostaglandins in previous cesarean patients, its use has been discouraged as ripening agent in previous cesarean patients. This study was conducted to compare the efficacy and safety of Foley catheter with low dose oxytocin as cervical ripening agent in women with previous cesarean section (CS). Materials and Methods: This was prospective randomized study, including 60 women (30 in each group) with previous CS with unfavorable cervix who needs induction of labor after 28 weeks. Outcomes were analyzed in terms of change in Bishop score (BS), route of delivery and complications. Results: The BS before and after ripening between the two groups was similar (P > 0.05). However, the change in BS within each group was 3.07 and 3.30 in Foley and oxytocin group respectively and this was statistically significant (P < 0.001). Twenty (66.7%) patients in Foley group had a vaginal delivery and 18 (60%) in oxytocin group did so. There were two cases of scar dehiscence in oxytocin group and non in Foley group. Conclusion: Both Foley and low dose oxytocin are good cervical ripening agents in previous cesarean patients. However, the two cases of scar dehiscence in low dose oxytocin group is a concern of safety.

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