Oral versus vaginal prostaglandin for labor induction

To compare the efficacy and safety of oral prostaglandin (PG) in solution versus vaginal PG gel for labor induction.

A retrospective study.

Data from original obstetric records at a university hospital in Sweden 2012-2013.

In all women, oral PG resulted in vaginal birth (VB) < 24 h in 66% compared to 80% with vaginal PG (p < 0.001), and cesarean section (CS) in 19% versus 32% (p = 0.02). In primiparous women, oral PG was followed by VB  <24 h in 54% compared to 71% (p = 0.01), and CS in 25% versus 41% (p = 0.03). In women with an unripe cervix, oral PG lead to VB  <24 h in 66% compared to 79% (p = 0.01), and CS in 21% versus 33% (p = 0.04). Despite a longer induction to vaginal delivery interval with oral PG, the rates of obstetric bleeding, chorioamnionitis, and neonatal asphyxia were not increased.

Oral PG in solution was less effective than vaginal PG gel in achieving VB  <24 h. However, oral PG was safer, since it resulted in fewer CSs without increasing maternal morbidity or neonatal asphyxia.