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• Induction of labor (IOL) is the process to initiate labor by artificial means from 24 weeks of
gestation.
• IOL occurs in over 20% of pregnancies and most commonly applies to cases where there are
deviations from the normal physiological processes such as hypertension or diabetes or fetal
problems such as fetal growth restriction or macrosomia
• Determining the effectivity of misoprostol vs oxytocin can help guide the management in
induction of labor
POPULATION
Inclusion criteria
alive singleton pregnancy
cephalic presentation
gestational age of 37 completed weeks and above
Exclusion criteria
grand multiparity (>5 deliveries)
women with previous lower segment caesarean section (LsCs)
antepartum hemorrhage
prelabor rupture of membrane (PROM)
INTERVENTION
Maternal complication
Fetal outcome/ complications
Induction method Mean Apgar score (SE) at 2 mins Mean Apgar score (SE) at 5 mins
• Observational study
ARE THE RESULTS OF THE STUDY VALID?
A.Primary Guides:
1.Was the assignment of patients to treatment randomized?
NO
2. Were all patients who entered the trial accounted for and attributed at its
conclusion?
YES
3. Was follow up complete?
NO
4. Were patients analyzed in the groups to which they were
randomized?
NO
B. Secondary Guides:
1.Were patients, health workers, and study personnel “blind” to
treatment?
NO
Were the groups similar at the start of the trial?
NO
3. Aside from the experimental intervention, were the groups treated
equally?
YES
4. Can the results be applied to my patient care?
In this trial, the data could not rule out a relevant difference in favor of elective repair with regard to the
primary endpoint. Nevertheless, in view of all other findings, authors of this study feel that the results justify
watchful waiting as a reasonable alternative compared with surgery in men aged 50 years and older.
INTERN’S CONCLUSION