Frequency of Adverse outcomes after Induction of Labor by Intracervical Catheterization with Prostaglandin Tablet in Eclamptic Patients in Mardan Medical Complex
DOI:
https://doi.org/10.70749/ijbr.v3i6.1901Keywords:
Eclampsia, Intracervical Catheter, Labor Induction, Cesarean Section, Neonatal Death.Abstract
Background: Eclampsia is a life-threatening hypertensive disorder complicating pregnancy and causing extensive maternal and neonatal morbidity. Induction of labour in such patients poses clinical difficulties in mode of delivery as well as neonatal outcome. Intracervical catheterization with supplementary prostaglandin therapy has been widely used, though results by this method have been sparse in local practice. Objective: To determine the frequency of adverse outcomes after induction of labour by intracervical catheterization with prostaglandin tablet in eclamptic patients in Mardan Medical Complex. Study Design: Descriptive cross-sectional study. Duration and Place of Study: The study was conducted from January to July 2024 at the Department of Obstetrics and Gynaecology, Mardan Medical Complex, Mardan. Methodology: A total of 172 eclamptic women aged 18–40 years, with singleton pregnancies beyond 36 weeks of gestation, were enrolled using non-probability consecutive sampling. Labor induction was initiated with a No. 16 Foley catheter and 50 micrograms of vaginal misoprostol, with repeated doses administered as needed. The catheter was removed after 12 hours or earlier based on labor progression or fetal condition. Cesarean section and neonatal death (within 72 hours of birth) were recorded as primary outcomes. Results: The mean maternal age was 29.49 ± 6.72 years, and mean gestational age at delivery was 38.71 ± 1.68 weeks. Cesarean section occurred in 47.1% of cases, while early neonatal death was observed in 5.2%. Cesarean delivery was significantly associated with higher parity (p=0.005), while neonatal death showed a higher, though statistically non-significant, trend in older mothers and post-term pregnancies. Conclusion: Labor induction using intracervical catheterization in eclamptic patients is associated with a high rate of cesarean delivery and a modest risk of neonatal death.
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References
1. Laskowska, M. (2023). Prevalence, diagnosis, and management of eclampsia and the need for improved maternal care: A review. Medical Science Monitor, 29.
https://doi.org/10.12659/msm.939919
2. Akre, S., Sharma, K., Chakole, S., & Wanjari, M. B. (2022). Eclampsia and its treatment modalities: A review article. Cureus.
https://doi.org/10.7759/cureus.29080
3. Miller, E. C., & Vollbracht, S. (2021). Neurology of Preeclampsia and related disorders: An update in neuro-obstetrics. Current Pain and Headache Reports, 25(6).
https://doi.org/10.1007/s11916-021-00958-z
4. Kalambe, M. A., Soni, N. N., Ali, S., & Bankar, N. J. (2024). An Observational Study of Maternal and Perinatal Outcome in Preeclampsia Cases in a Tertiary Care Center. Cureus, 16(4).
https://doi.org/10.7759/cureus.59352
5. Katsi, V., Svigkou, A., Dima, I., & Tsioufis, K. (2024). Diagnosis and treatment of eclampsia. Journal of Cardiovascular Development and Disease, 11(9), 257.
https://doi.org/10.3390/jcdd11090257
6. Wen, Y., & Yang, X. (2022). clinical comparison of preterm birth and spontaneous preterm birth in severe Preeclampsia. Contrast Media & Molecular Imaging, 2022(1).
https://doi.org/10.1155/2022/1995803
7. Biju, N., & Backer, C. (2025). Hidden Preeclampsia leading to placental abruption and disseminated intravascular coagulation. Cureus.
https://doi.org/10.7759/cureus.83469
8. Hackelöer, M., Schmidt, L., & Verlohren, S. (2022). New advances in prediction and surveillance of preeclampsia: Role of machine learning approaches and remote monitoring. Archives of Gynecology and Obstetrics, 308(6), 1663-1677.
https://doi.org/10.1007/s00404-022-06864-y
9. Pierce, S., Bakker, R., Myers, D., & Edwards, R. (2018). Clinical insights for cervical ripening and labor induction using prostaglandins. American Journal of Perinatology Reports, 08(04), e307-e314.
https://doi.org/10.1055/s-0038-1675351
10. De los Reyes, S. X., Sheffield, J. S., & Eke, A. C. (2018). Single versus double-balloon Transcervical catheter for labor induction: A systematic review and meta-analysis. American Journal of Perinatology, 36(08), 790-797.
https://doi.org/10.1055/s-0038-1675206
11. Socha, M. W., Flis, W., Pietrus, M., Wartęga, M., & Szambelan, M. (2023). The 300 versus 300 study—Low volume versus high volume single balloon catheter for induction of labor: A retrospective case-control study. Journal of Clinical Medicine, 12(14), 4839.
https://doi.org/10.3390/jcm12144839
12. De Vaan, M. D., Ten Eikelder, M. L., Jozwiak, M., Palmer, K. R., Davies-Tuck, M., Bloemenkamp, K. W., Mol, B. W., & Boulvain, M. (2019). Mechanical methods for induction of labour. Cochrane Database of Systematic Reviews, 2019(10).
https://doi.org/10.1002/14651858.cd001233.pub3
13. Jangra, H., Bagga, R., Kalra, J., Jain, V., Saha, S. C., & Kumar, P. (2023). Expediting labor induction in severe pre-eclampsia by earlier initiation of oxytocin after cervical ripening: A randomized study from India. Pregnancy Hypertension, 33, 1-7.
https://doi.org/10.1016/j.preghy.2023.05.002
14. Bakhsh, F. M., Gul, K., Bibi, S., & Gul, P. (2021). Induction of labor versus expectant management of patients with gestational hypertension at term. The Professional Medical Journal, 29(01), 57-61.
https://doi.org/10.29309/tpmj/2022.29.01.6237
15. Kaur, K., Kaur, B., Kaur, N., & Kaur, G. (2021). Intra-cervical Foley’s catheter or PGE2 gel for induction of labour: Which one is better: a prospective study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 10(5), 1802.
https://doi.org/10.18203/2320-1770.ijrcog20211417
16. Yousaf, M., Habiba, R., Ali, S., Kulsoom, O., Yasmeen, R., & Gul, R. (2022). Induction of Labour at Term: Comparison of Prostaglandin E2 with Foley Catheter. Pakistan Journal of Medicine and Dentistry, 11(1), 50–55.
https://doi.org/10.36283/pjmd11-1/009
17. Habib, A., Syed, F., Jamal, F., & Rehman, F. (2025). Comparative study of intracervical catheter and tablet prostaglandin for induction of labour in postdated pregnancy. Khyber Journal of Medical Sciences, 18(1), 108-112.
https://doi.org/10.70520/kjms.v18i1.696
18. Mundle, S., Bracken, H., Khedikar, V., Mulik, J., Faragher, B., Easterling, T., Leigh, S., Granby, P., Haycox, A., Turner, M. A., Lightly, K., Ebringer, M., Alfirevic, Z., Winikoff, B., & Weeks, A. D. (2021). The induction with Foley OR Misoprostol (INFORM) study dataset. A dataset of 602 women with hypertensive disease in pregnancy, in India, randomised to either Foley catheter or oral misoprostol for induction of labour. BMC Research Notes, 14(1).
https://doi.org/10.1186/s13104-021-05772-9
19. Singh, B. S., Joshi, K., & Pajai, S. (2023). Intra-cervical Foley balloon catheter versus prostaglandins for the induction of labour: A literature review. Cureus.
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