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Objective: To evaluate the outcome of combined method of induction of labour (low dose prostaglandin E2 gel and
intracevical Foley catheter) in terms of effectiveness and safety for induction of labour in women with previous caesarean
section at term.
Material & Methods: This prospective descriptive study was carried out in Obstetrics & Gynecology Unit B, Lady
Reading Hospital, Peshawar, Pakistan, from January 2015 to March 2016 It included 54 women with previous one
lower segment caesarian section, with unfavorable bishop score who were induced with combined intracevical Foley
catheter and low dose prostaglandin E2 gel (1mg) vaginally. All women reassessed after 8 hours and if bishop score not
improved second dose of 1mg prostaglandin E2 gel inserted. Induction to delivery interval, mode of delivery, number
of women delivering with in 24hours, indication for repeat C-section, maternal and neonatal outcome was assessed.
Results: Of the women 83.33% had a vaginal delivery and 16.67% had emergency caesarian section. Mean induction
to delivery interval was 12.38 hours (range 10-24 hours). The most common indication for repeat caesarean section
was arrest of progress in first stage of labour. Most common maternal complication was primary post partum haemorrhage
(PPH) (7.4%).There was no case of uterine rupture. Similarly, no case of maternal mortality recorded. 88.88% of
neonates had Apgar score of 8/10, 10/10 at 5 minutes and no perinatal mortality observed.
Conclusion: Induction of labour with combined low dose PG E2 gel and intracervical Foley catheter seems to be safe
and effective method for women with previous caesarean section at term.
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