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Vaginal prostaglandins for the ripe cervix
C Casey1, J Kehoe, M J Mylotte
1Department of Obstetrics and Gynaecology, University College Hospital, Galway, Ireland.
Objectives:
To assess the efficacy of vaginal prostaglandin (PGE2) tablets for induction of labor in the presence of a ripe cervix.
Methods:
A randomized controlled trial was performed. Two hundred and nine consecutive women undergoing induction of labor with a Bishop Score > or = 5 were randomly assigned to (a). Study group receiving PGE2 tablets (n = 106) and (b). Control group having artificial rupture of membranes only (n = 103). The duration of labor, oxytocin and analgesia requirements, the mode of delivery, complications and duration of confinement were recorded.
Results:
Mean duration of first stage of labor was shorter in parous patients in the study group (194 min v. 319 min), as was the mean induction delivery interval in primigravidas. Oxytocin was used in 75% of primiparas and 40% multiparas in the study group compared with 100% and 80%, respectively, in the controls. Epidural analgesics and instrumental delivery rates were also reduced.
Conclusions:
The use of vaginal PGE2 tablets for induction of labor with a ripe cervix is associated with a shorter first stage of labor and with reduced requirements for oxytocin, analgesia and instrumental delivery.