Induction of labor using intracervical prostaglandin E2 gel: the outcome

A prospective study was undertaken to evaluate the safety and efficacy of a 3 mg prostaglandin E2 (PGE2) gel applied intracervically for the initiation of cervical ripening before the induction of labor. All patients were required to have an initial Bishop score of 4 or less. The 3 mg PGE2 gel was found to be an effective method of cervical ripening in primigravida and multigravida with a success rate of 76 and 86.8 per cent after the first application to 96.4 and 97.4 per cent after third application respectively. The mean induction to delivery time was 22 hours in primigravida and 13 hours in multigravida. The mean amniotomy to delivery time was 6 hours and 4 hours in primigravida and multigravida respectively. However, the incidence of cesarean section was not improved as expected and there was one instance of uterine hyperstimulation. The only serious complication was one uterine rupture that occurred in multigravida with the prolonged use of oxytocin.