Use of prostaglandin E2 topical cervical gel in high-risk patients: a critical analysis

This investigation compared the safety and efficacy of 3- and 5-mg doses of prostaglandin E2 topical gel used for cervical ripening in 60 high-risk obstetric patients before oxytocin induction of labor. Both dosages significantly increased the Bishop score, unrelated to parity or gestational age. Induction time was significantly shortened, and the average maximum amount of oxytocin required was significantly less with the 5-mg dose, but not with the 3-mg dose, when compared with a placebo. Prostaglandin E2 did not influence the cesarean section rate. Uterine contractions were stimulated in 87.5% of the patients who received the drug, and 37.5% went into active labor, suggesting that prostaglandin E2 in these dosages is not an appropriate agent for local cervical ripening.