Intravenous oxytocin and oral prostaglandin E2 for ripening of the unfavourable cervix

Abstract

A clinical trial involving 60 patients was conducted to assess the relative efficacy of intravenous oxytocin and oral prostaglandin E2 in ripening the unfavourable cervix, when given as a priming dose on the day before induction of labour. There was significant improvement in the Bishop score, and the subsequent induction-delivery interval following priming with prostaglandin. This improvement appeared to be dose-related.

PIP: Sixty patients in need of labor induction were observed to compare the effectiveness of oxytocin and of prostaglandin E2 (PGE2) in ripening the cervix. Initial Bishop score was 4 or less in all patients. Patients were divided into 4 groups: A) controls, to whom no medication was given; B) who were given intravenous oxytocin on an incremental regime; C)oup C who were given 0.5 mg PGE2 orally every hour for 10 hours; and, D) who were given 1 mg of PGF2 hourly for 10 hours. All patients were brought to the delivery room at the same time the following morning and oxytocin was again injected till labor was established. Labor was significantly shorter in group D than in groups A, B, or even C. A 1 mg dose of oral PGF2 hourly for 10 hours the day before delivery seemed to be an effective method to deal with the problem. There were no maternal side effects and only 1 case of fetal distress, which was solved by cesarean delivery.