Induction of labour is a widely used practice in obstetrics. It is the process of artificially stimulating the uterus to start labour and expulsion of fetus prior. The commonly used methods for induction of labour are mechanical methods such as osmotic dilators, balloon catheters, amniotomy and pharmacological methods such as oxytocin infusion and prostaglandins. Among mechanical methods, Dilapan-S is the second generation osmotic hygroscopic dilator. It is a synthetic gel rod acting by absorbing fluid from the cells of the cervical canal, resulting in reversible cell wall dehydration and softening. By its mechanical stretch, it increases the volume of the rod(s) initiating the endogenous prostaglandin release causing collagen degradation and ripening of the cervix. Objectives of the study:
1. To determine the efficacy and safety of Dilapan-S, an osmotic cervical dilator in induction of labour.
2. To assess the maternal and perinatal outcome following induction with Dilapan-S.
Results: This study was performed on 55 pregnant. Syntocin augmentation was required in 42(72.4%) total, among which 13(61.9%) were primigravida and 29(85%) were multigravida. There was statistical significant difference in the requirement of syntocin augmentation distribution with respect to parity. In almost all vaginal deliveries and vaccum assisted vaginal delivery there was 100% need of syntocin augmentation showing significant difference in need of syntocin augmentation distribution with respect to mode of delivery. Out of 55 cases who underwent induction, 60% had vaginal delivery of which 8 were primigravida and 25 were multigravida, 38.2% had LSCS of 12 primigravida and 9 multigravida and 1.8% (one primigravida) had vaccum assisted vaginal delivery? There was a significant difference in mode of delivery distribution with respect to Parity.
Conclusion: Dilapan-S was effective method of induction of labour in terms of improving cervical ripening and vaginal delivery rate (60%) and was safe with no uterine hyper stimulation or maternal infections or mortality associated. There was need of syntocin augmentation for most of the patients (76.4%). Dilapan S was safe with good fetal outcome, reassuring type of CTG and with reduced need of NICU admission.