Preinduction cervical priming in high risk pregnancy--experience with a new sustained release PGE2 vaginal film

Abstract

Experience with a new sustained release PGE2 formulation is presented. 111 high risk primiparae with very poor cervical scores (less than 3) were studied. In 59 patients, labour was induced by forewater amniotomy and I.V. oxytocin. In the remaining 52 patients, film containing 850 ug of PGE2 was inserted into the vagina to ropen the cervix 24 hours prior to induction of labour. Indications for elective delivery and maternal characteristics were similar in both groups. There were significant changes in the cervical state within 12 hours of vaginal insertion. By 24 hours, 19 patients receiving vaginal film (36.5%) had established labour of whom 13 proceeded to vaginal delivery. Significantly fewer patients in the priming group required Caesarean delivery. No untoward maternal or fetal side effects were observed. Safety, ease of administration and efficacy make this new PGE2 formulation a useful agent for priming of the very poor primiparous cervix prior to induction of high risk labour.