[Induction of labor by prostaglandins]

The synthesis pathways for prostaglandins (PG) are derived from membrane phospholipids via arachidonic acid. The prostaglandins are the most active substances in inducing maturation of the cervix. They include PGF2 alpha which induces contractions of the uterine muscle and PGE2, which is active on the cervical connecting tissue with no effect on the body. The authors recall the role of the prostaglandins in triggering the spontaneous onset of labour, and suggest the use of PGE2 in the artificial induction of labour. PGE2 can be administered by local or systemic route. The authors report their personal experience with cervical maturation in a retrospective study covering a wide range of clinical circumstances. A prospective study in cases of premature rupture of the membranes, already reported, concludes that labour is induced earlier in a population receiving PGE2 than in a control population. The authors then discuss the literature data and stress the possible use of PGF2 alpha. To conclude, if prostaglandin-induced maturation appears to be more effective, it is nonetheless not the ideal method in view of the side effects and concomitant effects on uterine labour and the cervix. This method has the advantage of being usable in difficult cases.