A 32 years old female with 35 weeks pregnancy, G2P1 A0, chronic alcoholic for the past 2 years (around 30-60 ml/day according to relatives) presented to emergency services three hours after alleged history of savlon poisoning with complaints of moderate to severe pain in abdomen, periumblical, non radiating and associated with multiple episodes of vomiting, dyspnoea and altered sensorium. There was no history of haemetemesis or seizures. The patient had unintentionally ingested savlon at night time and vomited after 20 minutes of ingestion. The patient become restless and vomited four times in 20 minutes. After that the relatives brought her to emergency department of the hospital.The patient developed changes due to savlon ingestion causing aspiration and hypoxia. The patient had cardiac arrest in the emergency department and revived in 75 seconds .Rest of the management was done in ICU where patient initially extubated but next day due to alcohol withdrawal delirium tremens and pregnancy per se the patient was reintubated. The patient stayed in ICU for 16 days and then expired.
Morbidity and mortality from breast cancer can be reduced if detected early and breast cancer screening is the ultimate strategy for early diagnosis. Understanding the determinants that influence patient’s failure to embrace or participate in preventive care is a prerequisite for strategies to reverse the trend. Objective: This study was designed to identify the predictors of poor participation in mammographic breast cancer screening in our setting to encourage women to adopt preventive health care measures. Material and Methods: This was a questionnaire-based descriptive study whose validity was calculated using the Index of item Objective Congruence (IOC). Questionnaire administration and retrieval of responses were physically and electronically done. The entire study lasted for two months (July to August 2020). Results: Two hundred completed questionnaires were retrieved and analyzed. The mean age of the participants was 39.3 ± 14.6 years. A larger number 60.5% (n=121) of the participants had tertiary education. With regards to the level of the participants’ awareness of breast cancer, a large proportion of 91.5% (n=183) has heard of breast cancer. The majority 67.7% (n=135) of the participants had no family history of breast cancer. A greater number 87.5% (n=175) of the participants have heard of mammography as a breast cancer screening method. Most 41.5% (n=83) of the participants have not undergone mammography examination because none was in their vicinity, followed by those that we're afraid of radiation 28.5% (n=57) and the least 19% (n=18) attributed their reason of not going for mammography to the attitude of the attendants. Conclusion: In a resource-constrained setting, factors such as education, household income, availability, and affordability of breast cancer screening services are important predictors of participation in breast cancer screening exercises as documented in this study.
Background: Incomplete filling of Investigation Request Forms (IRF) by medical doctors is a common problem leading to pre-analytical errors and wrong interpretation of investigation results. Computers have been employed to alleviate the problem of incomplete filling of IRF in developed nations while the developing countries are still struggling with a lot of paper work. A good knowledge of the medical doctors’ reasons for non-complete filling of IRF may be the first step in solving these problems. This study was designed to determine the reasons behind the incomplete filling of IRF by medical doctors in Rivers State. Materials and Methods: This was a semi-structured, self-administered questionnaires-based descriptive survey conducted among consented medical doctors using hardcopy version of the questionnaire-based. The completed questionnaires were retrieved immediately and data generated in this study were collected using data proforma, and processed using SPSS version 21 (SPSS Inc., ILL, USA, 2003). The data were analyzed using descriptive statistics (tables, frequencies, percentages and bar chart). Result: Out of 88 respondents, the greater proportion 44.3% (n=39) of the respondents perceived inadequate time to complete the IRF as their reason for inability to incomplete filling of the IRF. Greater proportion 97.7% (n=86) of the respondents agreed that medical doctors should be trained and re-trained on complete filling of the IRF. The effect of an incomplete filling of IRF according to respondents include but not limited to; misinterpretation of results (n=60), delay in carrying out the investigation (n=86) and giving results to wrong patients (n=88). Conclusion: The commonest reason for incomplete filling of the IRF was inadequate time as there was usually much information to be filled. Interventions could result in a reduction of the errors and problems often created by incomplete filling of IRFs.
Encephalocele is characterized by a defect in cranial bone that results in protruding of the meninges (meningocele) or the meninges and the brain tissue (Encephalocele).Prenatal diagnosis can reveal a cranial defect with cerebral contents herniation of varying degrees, which are either purely cystic or may contain echoes of brain tissue. This paper focus on the encephalocele, prenatal diagnosis, associated syndromes as well as its management.
Background: With the increasing number of Coronavirus disease (COVID- 19) cases globally, we are faced with an unprecedented challenge of safe anesthetic management of parturient and health care personnel alike. Neuraxial anesthesia is the recommended choice for cesarean delivery in the COVID positive parturient unless otherwise contraindicated. The clinical manifestations of COVID-19 include Thrombocytopenia (Platelet count less than 150 × 109/L) and may influence the decision to administer neuraxial anesthesia for the fear of epidural hematoma. Other causes of thrombocytopenia in pregnancy include hypertensive disorders, gestational thrombocytopenia, and immune causes. Case: In this case report, we have reviewed and presented the anesthetic management of a COVID-19 positive, pre-eclamptic parturient with thrombocytopenia posted for an emergency cesarean section. Conclusion: The safe limit for platelet count for administering neuraxial anesthesia in COVID-19 positive parturient needs to be reconsidered and the single-shot subarachnoid block offers a safer alternative.
Background: During pregnancy, the fetal stores for any nutrient are dependent on the maternal’s status for that nutrient. Maternal anaemia is associated with adverse birth outcomes along with maternal morbidity and mortality respectively. Similarly, elevated Hb levels may lead to diminished fetal and placental nutrient and oxygen supply resulting subsequently in fetal, placental, and maternal complications. Objective: To explore (a) the relationship between event of fetal distress during term labour and intrapartum maternal haemoglobin level; (b) the relationship between mode of delivery, the reason for instrumental delivery and short-term neonatal outcome with maternal haemoglobin; and (c) Identify the factors influencing maternal haemoglobin level during the intrapartum period. Materials and Methods: A retrospective cohort study was conducted in a tertiary care hospital set-up of a rural district at Karnataka, India. Data were obtained from women who underwent parturition during the 2017-2018 period respectively. A total of 7173 gravidas were included. Multivariate regression models with intrapartum Hb as the main independent variable of interest was used to determine the likelihood of fetal distress to occur in relation to intrapartum Hb level dependency wherein Hb was used as a continuous value. The likelihood of Instrumental Vaginal Delivery (IVD), cesarean section (CS), 5 min Apgar score <7, and umbilical cord arterial pH 7.05 to occur was analysed using a similar procedure. In addition; linear regression analytics was done to identify factors influencing intrapartum Hb level. Results: Data of 7173 patients were analysed. Intrapartum Hb did not contribute to the prediction of the likelihood of fetal distress, IVD for non-progressive labour, CS for fetal condition, 5-min Apgar score <7, and pHa ≤ 7.05. However, there was a unique statistically significant contribution of Hb to the prediction of the likelihood of IVD for any reason and IVD for fetal distress and CS for any reason and CS for non-progressive labour. IVD for fetal distress was related to a higher intrapartum Hb level, whereas CS for non-progressive labour was related to a lower intrapartum Hb level. Factors identified to influence the intrapartum Hb level were maternal age, ethnicity, parity, fetal sex, and birth weight. Conclusion: The risk of fetal distress and the adverse neonatal outcome is not correlated to intrapartum Hb levels. However, on the other hand, our data suggest that intrapartum Hb is a detrimental factor for a mode of delivery. Keywords: Maternal haemoglobin; Fetal distress; Instrumental delivery; Neonatal outcome; Obstetric labour
PCOS (Reproductive Metabolic Syndrome) is the most common endocrine disorder in women of reproductive age group (5-15%). One of the major criteria for diagnosis is clinical or biochemical (Total testosterone >55ng/dl or free testosterone 9pg/ml) hyperandrogenism. There has always been a disparity between FG score and Testosterone (T) levels in PCOS women. Around half of those with mild hirsutism and small proportion of those with moderate-severe hirsutism are not associated with biochemical hyperandrogenism.
Conference Series is organizing “Global summit on Maternal, Infant and Child Health” which is going to be held during April 13-14, 2020 at Tokyo, Japan. The theme of the conference is “Bridging Excellence in Maternal and Child health”. The conference will cover the fields related to maternity, its care and complications.
Scope and Importance: Gynaecology and Women's health is referred to the fact that health problems face a wide variety of challenges: managing the care of patients of all ages that are specific to women anatomy. It relates to the unique issues which includes pregnancy, menopause, and conditions of the female organs. Women's health also includes medical situations in which women face problems not directly related to their biology but due to gender-differentiated access to medical treatment. Women's health issues have attained higher international perceptibility in the recent decades. Such as the United States has a higher ratio of maternal deaths than at least 40 other countries, even though it spends more money per capita for maternity care than any other. Maternal deaths must be reviewed to make motherhood safer. The status of maternal deaths in the United States was part of a larger report on the global, regional, and national levels and causes of maternal mortality from 1990-2013. The findings suggest that only 16 countries will achieve a target of a 75% reduction in the maternal mortality ratio (or number of maternal deaths per 100,000 live births) by 2016.
Background: Maternal and neonatal mortality remain a major problem in developing countries. Facility-based maternal death review is a process to investigate and identify causes mainly clinical and systemic which lead to maternal deaths in the health facilities and to take appropriate corrective measures to prevent future such deaths. Objective: To assess the prevalence of maternal and neonatal death and identify preventable causes of maternal deaths in selected Hospitals of Wollega Zones. Methodology: Institutional based cross-sectional study was conducted. Documents and chart reviews were conducted using a standardized checklist. Maternal and neonatal deaths that occurred during 2014-2016 were included. Ethical clearance was obtained from the Institutional Health Research Ethics Review Committee of Wollega University. Data was entered and analyzed using SPSS version 20 statistical packages for windows. Result: Sixty-nine (69) maternal deaths and 182 neonatal deaths occurred in five hospitals in the last three years from 2014-2016. The most common cause of maternal death was hemorrhage 36 (52.2), sepsis 23 (33.3), delay in health-seeking 20 (29%), and lack of transportation 19 (27.5%). The majority of the deceased were referral cases 54 (78.3%) and Most of them were admitted with complications 51 (73.9%). Majority of the neonatal death happened within 24 hours 100 (54.9). The majority of the deceased newborn were admitted with a diagnosis of prematurity 56 (30.8) followed by sepsis 42 (23.1%). Lack of materials in Neonatal Intensive Care Units was the major cause of neonatal death. Conclusion and Recommendation: Mothers and newborn were dying of preventable causes like hemorrhage, sepsis, lack of partograph utilization, and lack of facilities in the Neonatal Intensive Care Unit. Therefore, Health professionals should focus on and manage emergencies like hemorrhage, sepsis and should utilize partograph for all laboring mothers as per the guideline, and also they should council and promote individual birth plan to reduce delays in seeking health facility. Health facilities should equip the Neonatal Intensive Care Unit with all necessary drugs and materials.
Gynaecology or gynecology is medical practice dealing with health of female reproductive system (vagina, uterus, and ovaries) and breasts. Outside medicine, term means the science of women. Its counterpart is andrology, which deals with medical issues specific to male reproductive system. Almost all modern gynaecologists are also obstetricians. In many areas, specialities of gynaecology and obstetrics overlap.
The tale (COVID-19) is brought about by another strain of Covid (SARS CoV 2). In December 2019, the principal instances of the COVID-19 episode were accounted for in Wuhan, China, which was communicated around the world. As of July 3 2020, the World Health Organization (WHO) has revealed that 10,719,946 instances of COVID-19 have been affirmed all around the world, along with 517,337 COVID related passing. The Royal College of Obstetricians and Gynecologists (RCOG) delivered rules for pregnant ladies during the pandemic. They encouraged pregnant ladies to keep on getting arranged antenatal consideration except if they require selfisolation. The utilization of virtual discussion techniques should be considered as opposed to eye to eye contact. Likewise, pregnant ladies are encouraged to keep up social separating and use facemasks. Besides, folic corrosive and nutrient D enhancements are suggested. At each visit, the emotional wellness of the patient should be evaluated. Eager ladies are urged to step through an examination in the event that they create indications of COVID-19. On the off chance that a patient is discovered to be positive for COVID-19 what's more, requires hospitalization, the maternity staff part in charge should be educated before the patient entering the clinic. Staff should wear suitable individual defensive hardware (PPE), and the patient should be inspected in an disconnection room. During work, oxygen immersion should be above 94%. All pregnant ladies are encouraged to have a venous thromboembolism (VTE) appraisal and should be directed prophylactic measures appropriately. Eager ladies must abstain from taking headache medicine and stop thromboprophylaxis in the event that they present with thrombocytopenia (platelets <50). Looking for hematology counsel is suggested [13] . Enquiring about the beginning of new indications, for example, hack, high temperature, loss of (or change in) typical feeling of taste or smell (anosmia) is suggested. For gentle manifestations, ladies are encouraged to stay at home and go through a test. In the event that the test outcome is positive, ladies are encouraged to self-detach at home right away for in any event 14 days from the beginning of manifestations and dodge contact with other family individuals. Pregnant ladies need to alert those with whom they have had close contact and they should think about having contracted COVID-19 on the off chance that they build up any side effects. Staying at home for 14 days will forestall the spread of the sickness to others in the network. Other preventive measures incorporate washing hands consistently for 20 seconds utilizing cleanser and water, utilizing hand sanitizer, obstructing the mouth when hacking and sniffling, utilizing facemasks, evading guests, and drinking enough water. Ladies should look for clinical conferences if the side effects deteriorate [14]. It is suggested that all ladies who are conceded to clinic for maternity care should be tried for COVID-19 utilizing RT-PCR swabs, whether or not they have indications [15]During the Covid pandemic, pregnant ladies need more care with respect to their previous ailments, particularly if they have COVID-19. Obstetricians and gynecologists need to team up with different controls to help contain this pandemic.
Background- Delivery of a deeply impacted fetal head in second stage cesarean is associated with adverse fetal and maternal outcomes. Objective- To compare maternal and neonatal morbidities by Patwardhan technique and Hand-Push method for delivery of the impacted fetal head during cesarean section at full cervical dilatation. Methodology- Retrospective cohort study which included 100 women admitted to J.J.M Medical College, Davangere with single fetus at term in vertex position with head deeply impacted in the pelvis that underwent second stage caesarean section with fetal head at or below the level of ishchial spine from October 2018 to September 2019. In the first group all cases were extracted by Patwardhan and in the second group extraction of fetus was done by Hand-Push method. Results- Extension of uterine incision was seen in 2% of patients in Patwardhan group as compared to 16% in Push Method. Traumatic PPH, uterine artery laceration, need for blood transfusion and hysterectomy were more in Push method. NICU admissions were comparable in both the groups. APGAR score comparison between the two methods of extraction at 1min (p=0.015) and at 5min (p=0.01) indicated that Patwardhan group showed considerable advantage over the Push method. Conclusion- The Patwardhan technique is safer and better than the Push method during delivery of a deeply engaged fetal head in cesarean section at full cervical dilatation.
Mechanical ventilation is a type of respiratory support therapy frequently used in pregnant patients in intensive care or during the intraoperative period, and understanding the physiological and pathophysiological changes in the respiratory system that are caused during pregnancy and its complications is key to management. Strategic knowledge of mechanical ventilation is essential to limit damage and reduce maternal and fetal morbidity and mortality.
Unconstrained film break that happens before the beginning of work is named as untimely break of layers (PROM). Prelabor break of layers before the 37th seven day stretch of incubation, named preterm untimely break of layers (PPROM), is a typical obstetric entanglement which happens in roughly 3-4.5%, all things considered. PPROM is related with 30% of neonatal morbidities and mortalities in preterm conveyance and remains a test for the obstetrician. Intense irritation of the films, chorioamnionitis, shows high danger of unfriendly neonatal results. Chorioamnionitis is normally the consequence of microbial intrusion in patients with PPROM and PROM, however can likewise be brought about by genital mycoplasmas, for example, Ureaplasma and Mycoplasma hominis or foundational disease inspite of flawless layers. Clinical chorioamnionitis is determined in patients introducing to have at least two of the following rules: high temperature, maternal tachycardia, fetal tachycardia, uterine delicacy, putrid amniotic liquid, maternal leukocytosis with groups, and positive C receptive protein. Maternal serum C-responsive protein (CRP) has been concentrated as an extra in the finding of subclinical contamination among pregnant ladies with preterm work or preterm break of layers. CRP is an intense stage protein created in the hepatocytes of the liver, and is ordinarily present as a follow constituent in the serum. A huge ascent in the fixation is seen following injury and aggravation. Once delivered, CRP will undoubtedly modified or necrotic layer structures, and its organic impacts incorporate improvement of phagocytosis, incitement of leucocyte motility and opsonic impacts, proposing a particular job in tissue recovery. Conceivable humoral arbiters are the macrophages of the endothelial framework, the endogene pyrogens and the prostaglandins. Maximal fixations are seen 24- 48 h after the instigating improvement. The half-time is 8-9. CRP isn't moved across the placenta. Different non-obtrusive markers have been concentrated to analyze chorioamnionitis in the preclinical stage. The lab pointers regularly used to foresee intra-amniotic contamination are complete leucocyte check (TLC), differential leucocyte tally (DLC), pee culture, vaginal culture. The current examination was led with the intend to think about maternal CRP and WBC include in foreseeing intraamniotic disease in pregnancies muddled with crack of films.
I am pleased to mention that during the year 2019, all issues of volume 5 were published online well within the time and the print issues were also brought out and dispatched within 30 days of publishing the issue online. During the calendar year 2019, Critical Care Obstetrics and Gynaecology received a total of 66 papers, out of which 34 articles (53%) were rejected in the preliminary screening due to plagiarism or being out of the format and peer review process. During 2019 around 24 articles were subjected for publication after they are accepted in the peer review process. In the 4 issues of Volume 5 published during the year 2019, a total of 24 articles were published (at an average of 6 articles per issue) of which, articles were published from authors all around the world. A total of 95 research scientists from all over the world reviewed the 34 articles published in volume 5. Average publication lag time of an article was further reduced to 2-3 weeks. During the calendar year 2019, a total of 10 Editors, 24 Reviewers joined the board of Critical Care Obstetrics and Gynaecology and contributed their invaluable services towards contribution as well as publication of articles. I take this opportunity to acknowledge the contribution of Hua-chuan Zheng (Editor-in-Chief) during the final editing of articles published and the support rendered by the editorial assistant, (Emy Carl) in bringing out issues of Critical Care Obstetrics and Gynaecology in time. I would also like to express my gratitude to all the authors, reviewers, the publisher, the advisory and the editorial board of Critical Care Obstetrics and Gynaecology, the office bearers for their support in bringing out yet another volume of Critical Care Obstetrics and Gynaecology and look forward to their unrelenting support to bring out the Volume 6 in scheduled time.
Coronavirus disease 2019 (SARS-CoV-2) is an emerging pandemic disease. Coronaviruses cause illness spectrums changing from the common cold to serious respiratory illness and death. Available data about coronavirus disease 2019 during pregnancy are limited because of the limited studies. However, no vertical transmission maternal to fetal is proven in recent studies. Pregnancy complicated with Coronavirus can cause spontaneous abortion, miscarriages, preterm deliveries, intrauterine growth restriction, and fetal demise. Pregnancy complicated with Coronavirus can be due to severe acute respiratory syndrome, disseminated intravascular coagulopathy, renal failure, secondary bacterial pneumonia, and sepsis. And also maternal infection during pregnancy contribute elevated cytokines leading to cytokine-storm. Cytokine-storm-related Coronavirus 19 infection at pregnancy can deteriorate fetal development. Fetal neuronal dysfunction, atypical behavioural phenotypes, autism, and attention-deficits are related to viral infections at the time of pregnancy.
A 35 years female, G2P1 with one living youth from past cesarean portion was admitted to the mending community for emergency cesarean portion in light of certified work tortures and burst of layers with all around controlled GDM on insulin at 39 weeks of brooding. Cesarean portion was done with dynamic organization of third period of work was done by applying prophylactic echobolics in sort of oxytocin and PGE1. The uterus was a lot of contracted with unimportant vagina depleting. The understanding was moved to ward in incredible condition. The uterus was especially contracted with immaterial vaginal depleting yet after 2hrs, spout of vaginal depleting occurred with blood clusters, PV assessment revealed extended cervix with blood bunches in the lower uterine part with contracted upper bit that was avowed on ultrasound by unfilled upper segment and extended lower with blood bunches (Figure 1). Her vitals were ABP 100/60, HR 95 B/M, HB 9.5 after preoperative 11.5 gm% so we started echobolics in kind of oxytocin 20 iu/500 cc saline more than 4 hrs, 800 mcg PGE1 and methergin amp 0.5 mg IM. No preliminary of ejection of blood groups from lower area as it went about as hemostatic tamponade be that as it may, echobolics will eliminate the substance with compressions all through the accompanying couple of days as changed blood and faint bunches. Furthermore fluids were given. The conditions decided with this measure an old changed cluster were removed all through the accompanying 3 days with no fresh leaking with stable general condition. Other options that could help in development is inflatable tamponade of the lower area, pressure stitches, stepwise devascularize, respective inside iliac stock course ligation, hysterectomy or radiological embolization. Baby blues sickliness was reconsidered using iron dextran (cosmofer) by total dose blend, where the dose was found out as takes after 0.24*deficits (target-acual hb)*body weight+500. The figured estimations is in mg press that can be used as a single imbuement more than 4 and half hours after test estimation of the underlying 25 mg over 15 minutes at that point twofold drop. Each ampoule contains 100mg in 2ml. The total estimations should not to outperform 20mg/kg. The typical augmentation in hemoglobin is 1.5 gm/week what's more, Hb checked after about fourteen days that outperformed 12 gm % and oral iron is allowed following 5 days from imbuement to keep a key separation from decrease in its retention. Other iron arranging as iron sucrose can be used at this point seclude estimations to be superseded every 2-3 days with most noteworthy 2 ampoules in 200cc slowly after test dose more than 1-2 hrs the writing in respects to this issue is pitiful accordingly obliged.
The craft of forceps conveyance is a training that goes back a few centuries. Current obstetrics practice has seen an expansion in the cesarean segment rates. The objective of forceps conveyance is to mirror unconstrained vaginal birth, subsequently speeding up conveyance with at least maternal or neonatal dreariness. Its protected and appropriate use can diminish the increasing cesarean area rates. This examination is expected to see the result of its utilization in a showing emergency clinic over a 1 year time span. In this Prospective observational examination, 158 instances of forceps conveyance were read for maternal result, for example, wounds, failue of forceps, baby blues discharge, need of blood bonding and neonatal result, for example, birth weight, Apgar scores, neonatal emergency unit confirmations or any fetal grimness or mortality. Out of the 158 patients, 76.58% of patients requiring forceps application were primigravida. The most normal sign was fetal pain (55.69%) trailed by maternal fatigue. The most well-known maternal confusion was maternal wounds, for example, vaginal cuts. (9.49%), 3 instances of disappointment of forceps conveyance (1.89%), vulvovaginal hematoma in 2 cases, 6 instances of complete perineal tears with 6 instances of Postpartum drain requiring blood bonding. There was 1 instance of uterine break which was in a past lower fragment cesarean area case. Out of complete of 15 infants (9.49%) who had poor Apgar scores 14 recuperated after revival with 1 instance of stillbirth where fetal pain was sign of forceps conveyance. Forceps is an extensive and safe alternative for the obstetrician to lessen the cesarean area rates; notwithstanding, extraordinary alert, appropriate skill and legal utilization of this instrument is needed to forestall excessive danger to mother and baby.
Background: Among the reported adverse effects of labor induction, little has been documented about postpartum bleeding. In our population where anemia is a common problem, any significant amount of blood loss beyond what the individual may be able to tolerate may compromise hemodynamic status resulting in additional therapy, with increased healthcare costs. The best agent and method for the induction of labor remains uncertain. Objective: To evaluate and compare postpartum vaginal blood loss and efficacy of the combination of Foley's bulb and oxytocin with vaginal misoprostol alone for labor induction. Materials and Methods: A total of 200 pregnant women were randomized into two groups of 100 each for misoprostol (Group M-50 µgram intravaginal) or Foley's catheter with oxytocin (Group FO) as methods of induction. Blood loss was measured using a plastic collection bag and weighing of the pads up to 6 hours postpartum. Pre- and post-delivery hemoglobin (Hb) and hematocrit (HCT) were measured and differences assessed and analyzed. The main outcomes measured were the success of induction, induction-delivery interval, postpartum blood loss, and difference between pre- and post-delivery Hb and HCT levels. The analysis was done with IBM SPSS version 24.0 for windows. Results: Age, parity, gestational age, episiotomy, and perineal tears were comparable in both groups. The mean blood loss in group M (60.52 ± 54.68 g) was significantly higher than group FO (36.94 ± 27.79 g) (p=0.00). The differences between mean pre-delivery Hb and HCT levels (12.23 ± 1.32 g/dl; 38.18 ± 3.01% and 12.35 ± 1.31 g/dl; 38.25 ± 3.31% in group M and group FO respectively) and post-delivery Hb and HCT (10.53 ± 1.45 g/dl; 34.55 ± 4.22% and 10.45 ± 1.32 g/dl; 34.58 ± 4.15% in respective groups) were comparable between both groups. This difference was statistically insignificant (p>0.05). Whereas, within each group, pre and post-delivery Hb and HCT level differences were statistically highly significant (p=0.001). A mild positive correlation between postpartum blood loss and initial Bishop scores and induction delivery interval was seen in group FO as compared to no such correlation in group M. Induction to the delivery interval was shorter in group FO (11.43 ± 5.25 hours vs 12.49 ± 5.62 hours) (p=0.169). Conclusion: Induction with Foley's catheter with sequential use of oxytocin was found to be more efficacious as compared to intravaginal misoprostol for labor induction
