[A breech delivery and induction with prostaglandin E2]

Induction of labour with local application of PgE2 in breech presentation is still a much discussed problem. We aimed at studying the effect of local application of PgE2 (Prostin E2--3 mg) vaginal tablets for induction of labour in breech presentation. 15 pregnancies were studied and induced--8 for postdate, 6 for prae-eclampsia and 1 for fetal demise. Sonographic biometry and cardiotocographic examinations were conducted as well as a precise bishop score. Labour began within the interval of 3-13 hours after the application on the first tablet. The length of delivery was 4-24 hours. Effective labour was instituted in 93.33% on the parturiens, while in 1 (6.67%) there was a need for augmentation with oxytocin. There were no cases of hyperstimulation. Vaginal delivery was accomplished in 100% of the patients among which the breech was delivered with the classical manoeuvre in 10 cases and by the Bracht manoeuvre in 5 cases. Our results show, despite is small case number, that with favourable pelvic scores and absence of cephalopelvic disproportion and fetal distress PgE2 induction can be done locally even for breech presentation.