Labor characteristics of uncomplicated prolonged pregnancies after induction with intracervical prostaglandin E2 gel versus intravenous oxytocin

Abstract

Labor characteristics after intracervical application of 0.5 mg prostaglandin (PG) E2 gel (n = 83) versus intravenous administration of oxytocin (n = 82) for labor induction were investigated in uncomplicated prolonged pregnancies with unripe cervix. The induction to delivery time as well as the total oxytocin dose were significantly reduced in the PGE2 group (p < 0.001). Cesarean sections, instrumental deliveries and fetal distress had the same frequency, but the failures of trial were significantly higher in the oxytocin group than in the PGE2 group (20.7 vs. 6%, p < 0.01). Twenty-four percent of women needed a second PGE2 dose, and almost half of the women in the PGE2 group experienced 'spontaneous' labor. More neonates in the oxytocin group had 5-min Apgar scores < 7 (p < 0.05). Intracervical PGE2 gel application is superior to intravenous oxytocin in terms of shortening the induction-delivery interval and increasing the frequency of successful vaginal delivery. In addition, it is safe for mother and fetus.

PIP: Labor characteristics after intracervical application of 0.5 mg prostaglandin E2 (PGE2) gel (n=83) vs iv administration of oxytocin (n=82) for labor induction were investigated in uncomplicated prolonged pregnancies with unripe cervix. The induction-to-delivery time as well as the total oxytocin dose were significantly reduced in the PGE2 group (p0.001). Cesarean sections, instrumental deliveries, and fetal distress occurred with the same frequency, but the failures of trail were significantly higher in the oxytocin group than in the PGE2 group (20.7 vs 6%, p0.01). 24% of the women required a 2nd dose of PGE2, and almost 1/2 of the women in the PGE2 group experiences spontaneous labor. More neonates in the oxytocin group had 5-minute Apgar scores 7 (p0.05). Intracervical PGE2 gel application is superior to iv oxytocin in terms of shortening the induction-to-delivery interval and increasing the frequency of successful vaginal delivery. In addition, it is safe for both mother and fetus.