[Ambulatory treatment of prolonged pregnancy with prostaglandin E2 gel]

Abstract

Background: the rutinary labor induction with prostaglandin E2 (PGE2) in pregnancy at 41 weeks has showed a fetal benefit without an increase in maternal morbidity or cesarean delivery.

Objective: to show that the ambulatory management of prolonged pregnancy with PGE2 gel decreases the cesarean delivery and prenatal morbidity rates.

Methods: quasiexperimetal study of patients with an accurate dated pregnancy of 41 weeks and beyond were analyzed. The women were divided in two groups of 196 each one. In the treated group, the endocervical application of PGE2 was followed by cardiotocographic control. If there was no reason to interrupt the pregnancy they were evaluated twice a week. Perinatal outcomes, mode of delivery and indications for cesarean section were assessed in both groups.

Results: there was a decrease in rate of cesarean delivery in treated group, 43 % versus 54 % in control group (p < 0.05). Apgar score at 1 and 5 minute showed no difference, but there were two intrauterine deaths in control group. The indications for cesarean surgery were the same in both groups and there was a case of tachysystole in each one.

Conclusion: we concluded that decrease in the rate of cesarean deliveries without increments of fetal and maternal morbidity in this study, point to a secure management choice with PGE2 in ambulatory patients.