title: Concurrent oxytocin in women needing second dinoprostone.
abstract: OBJECTIVE
  To reduce average induction delivery internal in patients with poor Bishop score without compromising fetomaternal outcome (in terms of birth weight, NICU admission, maternal complications and mode of delivery).
  
  
  METHODS
  A descriptive study.
  
  
  METHODS
  Department of Obstetrics and Gynaecology, Pakistan Atomic Energy Commission (PAEC) General Hospital, Islamabad, from February to December 2009.
  
  
  METHODS
  All patients needing 2nd dinoprostone pessary for induction of labour were included in the study. Patients with gestation below 37 weeks, those with intra-uterine growth restriction, bad obstetric history, previous uterine scar and patients in whom Bishop score improved for amniotomy after 1st dinoprostone pessary, were excluded. Data was collected on a special proforma where all variables were defined.
  
  
  RESULTS
  Out of 90 patients, 44 (48.8%) had spontaneous vertex deliveries and 12 (13.3%) had instrumental deliveries so a total vaginal deliveries occurred in 56 (62.2%) patients. Thirty four patients (37.8%) had emergency caesarean sections. Main indication for cesarean was failure to progress in 1st stage of labour followed by fetal distress. There were 3 failed inductions. Only 2 patients had hyperstimulation. NICU admission were 8 and all babies were discharged healthy from nursery with no case of early neonatal death.
  
  
  CONCLUSIONS
  Concurrent oxytocin with 2nd dinoprostone in patients with poor Bishop scores (initial scores 2 and 3) resulted in more vaginal birth and comparatively shorter induction delivery time with almost negligible fetomaternal complications.
authors.affiliation: Department of Obstetrics and Gynaecology, Pakistan Atomic Energy Commission (PAEC), General Hospital, Islamabad.
authors.forename: Zaiba
authors.initials: Z
authors.lastname: Sher
authors.affiliation: Department of Obstetrics and Gynaecology, Pakistan Atomic Energy Commission (PAEC), General Hospital, Islamabad.
authors.forename: Mussaret
authors.initials: M
authors.lastname: Ashraf
authors.affiliation: Department of Obstetrics and Gynaecology, Pakistan Atomic Energy Commission (PAEC), General Hospital, Islamabad.
authors.forename: Nabila
authors.initials: N
authors.lastname: Irum
authors.affiliation: Department of Obstetrics and Gynaecology, Pakistan Atomic Energy Commission (PAEC), General Hospital, Islamabad.
authors.forename: Shaheen
authors.initials: S
authors.lastname: Bashir
authors.affiliation: Department of Obstetrics and Gynaecology, Pakistan Atomic Energy Commission (PAEC), General Hospital, Islamabad.
authors.forename: Nagina
authors.initials: N
authors.lastname: Khaliq
authors.affiliation: Department of Obstetrics and Gynaecology, Pakistan Atomic Energy Commission (PAEC), General Hospital, Islamabad.
authors.forename: Saima
authors.initials: S
authors.lastname: Yaqub
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D020070:Cervical Ripening; D036861:Delivery, Obstetric; D015232:Dinoprostone / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D010121:Oxytocin / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D010154:Pakistan; D010570:Pessaries; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D013997:Time Factors
chemical_list: D010120:Oxytocics; D010121:Oxytocin; D015232:Dinoprostone