Induction of labor by prostaglandin E2: intracervical gel or vaginal pessaries? (original) (raw)
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The effect of vaginal prostaglandin E2 pessaries on induction of labor
American Journal of Obstetrics and Gynecology, 1984
In a prospective randomized study, patients with a valid obstetric indication for induction of labor received either 3 mg prostaglandin E2 vaginal pessaries immediately prior to oxytocin (prostaglandin group, n = 99), or oxytocin alone (oxytocin group, n = 103). At the conclusion of the second day of induction, a significant reduction was noted in the incidence of failed induction in the prostaglandin group (4%) as compared to the oxytocin group (13%) (p < 0.05). Twenty percent of patients in the prostaglandin group experienced successful induction with prostaglandin pessaries only. When oxytocin was required in the prostaglandin group, the maximal concentration of oxytocin infused and the duration at this concentration were significantly less than in the oxytocin group. No perinatal complications were attributed to the use of prostaglandin. Three minor matemal complications that were attributed to vaginal prostaglandin E2 did not require treatment. Our conclusion is that patients who require an induction of labor, when artificial rupture of the membranes is not feasible, benefit from the use of prostaglandin pessaries before the administration of oxytocin. (AM.
Induction of labor by prostaglandin E2 in relation to the Bishop score
International Journal of Gynecology & Obstetrics, 2000
Objecti¨e: To compare the effectiveness of prostaglandin E intravaginal gel with the intracervical gel in patients 2 with an unfavorable cervix. Method: In a prospective multicenter trial 470 patients with unfavorable Bishop scores Ž . Ž . Ž . 3᎐4 were randomized to receive prostaglandin vaginal gel 2 mg or intracervical gel 0.5 mg . Results: In patients with unfavorable Bishop scores the intravaginal application route resulted in a better cervical ripening, a shorter Ž . induction to delivery interval and a higher cumulative rate of deliveries during 24 h Ps 0.01 . Conclusion: Intravaginal instillation of prostaglandin E gel for induction of labor is effective in patients with an unfavorable 2 Bishop score of 3᎐4. ᮊ
Outcome of induction of labor with prostaglandin E1 25 mg vaginal tablet – A retrospective study
Tropical Journal of Obstetrics and Gynaecology, 2019
Context: Labor induction with prostaglandin E1 (PGE1) vaginal tablet results in shorter induction delivery interval and decreased rate of failed induction of labor and reduced caesarean section rate. However, higher doses may be associated with uterine hyper stimulation. It is therefore necessary to determine the safe dose of PGE1 for labor induction. Aims: To assess the maternal and neonatal outcome with use of 25 mg vaginal misoprostol for induction of labor. Settings and Design: A retrospective analysis conducted in an obstetric department of a tertiary care teaching institute. Materials and Methods: The sample consists of women with singleton term pregnancy, with Bishop's score <6 compared with women with spontaneous onset of labor. Statistical Analysis Used: Statistical significance was assessed at 5% level of significance. Chi-square test, with correction for continuity where applicable, was carried out to compare proportions across subgroups or between induction and spontaneous onset groups. Results: The rate of vaginal delivery was higher among spontaneous onset group compared with induction group ( 2 (1) = 30.3, P < 0.001). The induction delivery interval of vaginal delivery was less than 24 h in 91.85% of women. Neonatal intensive care unit admission frequency was similar among both groups ( 2 (1) = 0.14, P = 0.704). The induction group was with less frequency of meconium staining than the control group ( 2 (1) = 8.05, P = 0.0046). Conclusion: Our study showed a higher rate of vaginal delivery with induction delivery interval less than 24 h in a majority of women with better neonatal and maternal outcomes.
Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term.
Cochrane database of …, 2003
Prostaglandins have been used for induction of labour since the 1960s. This is one of a series of reviews evaluating methods of induction of labour. This review focuses on prostaglandins given per vaginam, evaluating these in comparison with placebo (or expectant management) and with each other; prostaglandins (PGE2 and PGF2a); different formulations (gels, tablets, pessaries) and doses.
Oral versus vaginal prostaglandin for labor induction
Objective: To compare the efficacy and safety of oral prostaglandin (PG) in solution versus vaginal PG gel for labor induction. Design: A retrospective study. Methods: Data from original obstetric records at a university hospital in Sweden 2012–2013. Results: In all women, oral PG resulted in vaginal birth (VB)524h in 66% compared to 80% with vaginal PG (p=0.001), and cesarean section (CS) in 19% versus 32% (p=0.02). In primiparous women, oral PG was followed by VB 524h in 54% compared to 71% (p¼0.01), and CS in 25% versus 41% (p=0.03). In women with an unripe cervix, oral PG lead to VB 524h in 66% compared to 79% (p=0.01), and CS in 21% versus 33% (p=0.04). Despite a longer induction to vaginal delivery interval with oral PG, the rates of obstetric bleeding, chorioamnionitis, and neonatal asphyxia were not increased. Conclusions: Oral PG in solution was less effective than vaginal PG gel in achieving VB 524h. However, oral PG was safer, since it resulted in fewer CSs without increasing maternal morbidity or neonatal asphyxia. J Matern Fetal Neonatal Med, Early Online: 1–4 http://dx.doi.org/10.1080/14767058.2016.1190823
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: In modern medicine induction of labour is required in patients for a good feto-maternal outcome. PGE2 is a prostaglandin analogue which has been used as a cervical ripening agent to improve bishops score. Objective of this study was to evaluate the efficacy of intravaginal PGE2 gel as a cervical ripening agent in unfavourable cervix for induction of labor and any complications associated with its use.Methods: This study comprised of 90 women who required labor induction. Singleton pregnancy above 37 weeks, live intrauterine fetus, Cephalic presentation, Bishop score of 1-6, reactive FHR pattern were included. Women who required only single induction were categorized as Group 1. Those requiring more than one dose after reassessment of bishops scoring at 6, 12 and 18 hours belonged to Group 2.Results: Group1 had more of younger population below 30 years consisting more primigravidas with > 80% women having gestational age of > 39 weeks. Most common indication for ind...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: Induction of labor (IOL) is a process where labor is initiated artificially before its spontaneous onset for the delivery of feto placental unit by mechanical or pharmacologic methods.Methods: The present Hospital based prospective randomized comparative study was conducted in the department of obstetrics and gynecology, KLES Dr. Prabhakar Kore Charitable Hospital, Belagavi during the period of January 2015 to December 2015.The selected women were randomized into two groups by simple randomization using an opaque sealed envelope, into either without vaginal estradiol Group A: Group PGE2 - Prostaglandin E2 gel intracervical alone group or Group B: PGE2 + E (Estradiol) - combined Prostaglandin E2 gel intracervical and 50 µg of estradiol tablet intravaginal group.Results: In the present study 65% of the women in group PGE2 required three doses of prostaglandins compared to 23.33% in group PGE2 and estradiol for the cervix to become favorable. In this study there is signific...
Prostaglandin E2 vaginal suppository for induction of labour: an efficient, safe and popular method
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1987
Two different methods for induction of labour were randomly used in 100 women with a favourable cervix. The patients were treated with either prostaglandin vaginal suppositories containing 2.5 mg PGE, in a base of Witepsol S55 (Dynamit Nobel) or intravenous infusion of oxytocin. The PGE, vaginal suppository was significantly more efficient than the intravenous infusion of oxytocin in relation to the time interval from the start of induction of labour to delivery. Also the percentage of women who delivered within 48 hours (success rate) was higher in the suppository group. Significantly more women in the suppository group found this induction method recommendable.