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[Vaginal administration prostaglandin E2 in premature ruptured membranes at term with an unfavorable cervix]
B Carbonne1, F Goffinet, D Cabrol
1Maternité Port-Royal-Baudelocque, Paris.
Aim Of The Study:
To compare immediate labor induction by vaginal prostaglandins to immediate labor induction by oxytocin or to expectant management in case of prelabor rupture of the membranes at term.
Material And Methods:
A meta-analysis of all randomized trials indexed in Medline or in the Cochrane Database of Systematic Reviews comparing labor induction by vaginal prostaglandins to labor induction by oxytocin or to expectant management. The statistical analysis was performed according to Peto and Yussuf's modified Mantel Haenszel method. The results were expressed as odds-ratios.
Results:
Ten published studies meeting the above criteria were found. These trials included 1004 patients. When comparing labor induction by prostaglandins to expectant management, we observed a reduction of the admission-to-delivery interval, a decreased maternal and neonatal infection rate, without difference in the cesarean section rate. When comparing labor induction by vaginal prostaglandins to labor induction by oxytocin, a decreased cesarean section rate was observed without difference in maternal or neonatal infection rates.
Conclusion:
Immediate labor induction by vaginal prostaglandins provides better maternal and neonatal outcomes than labor induction by oxytocin or expectant management in case of prelabor rupture of the membranes at term.