Induction of labour in pregnancy complicated by heart disease

Thirty-seven patients whose pregnancies were complicated by heart disease and who required induction of labour were given 4 mg of prostaglandin E2 (PGE2) oral tablets per vaginam. Thirty-one patients (84%) went into labour and delivered within 24 hours, 28 of them vaginally. Although 3 infants had an Agpar score of less than 7 at birth, 2 having been delivered vaginally, all were discharged from hospital thriving and in good condition. No side-effects of PGE2 were observed and although these women had a wide range of functional disabilities, none developed deterioration in cardiac status. Vaginal administration of PGE2 for induction of labour is a safe and simple method of achieving elective delivery in patients with pregnancies complicated by heart disease.