Use of cervical prostaglandin E2 gel in patients with previous cesarean section

The aim of this study was to determine whether preinduction cervical ripening with prostaglandin E2 (PgE2) gel in patients with one previous cesarean section may be used with the same safety and efficacy as in patients without a uterine scar. Primiparous patients (n = 94) with one previous cesarean section were retrospectively compared to nulliparous patients (n = 866). Both groups underwent preinduction cervical ripening with 2 mg intracervical PgE2 gel. Logistic regression was performed to control for confounding factors. Our statistical power was 90% for detecting a doubling of the complication rate, from 10 to 20%. There were no significant differences in the duration of ruptured membranes or length of labor between the two groups. No significant differences were detected in the rate or indications for cesarean section, presence of thick meconium, epidural anesthesia use, amnionitis, or maternal and neonatal morbidity. There were no cases of uterine rupture in either group. PgE2 gel may be used with the same safety and efficacy in patients with previous cesarean section as in nulliparas.