Induction of labor with oral prostaglandin E2 and buccal demoxytocin without amniotomy

Abstract

The results of labor induction without primary amniotomy in 132 primi-parae are presented. Prostaglandin E2 was given orally to 40 patients, 45 were treated buccally with demoxytocin and 47 were given a combination consisting of demoxytocin on the first day and prostaglandin E2 on the second day. All patients had Bishop scores less than 7. No significant difference in the efficiency of induction between the three types of treatment was detected. The delivery rates 48 hours after the start of treatment were 45.0 per cent, 37.8 per cent and 46.8 per cent respectively. The incidence of complications was not increased in the group which received the combined treatment.

PIP: An investigation was conducted to determine whether a greater effectiveness of induction of labor could be obtained without amniotomy by using 2 labor-inducing substances with different modes of action: oral prostaglandin E2 (PGE2) and buccal demoxytocin. The 132 primpara patients, in whom induction of labor was indicated and who had Bishop scores below 7, were randomized into 3 treatment groups: prostaglandin E2 was given orally to 40 patients; 45 were treated buccally with demoxytocin; and 47 were given a combination of demoxytocin on the 1st day and PGE2 on the 2nd day. The delivery rate 48 hours after the start of treatment was 45.0% in the oral PGE2 group, 37.8% in the buccal demoxytocin group, and 46.8% in the combined group. These differences were not statistically significant. The overall incidence of vaccum-extractions, cesarean section and Apgar scores below 7 after 1 minute were 15.8%, 19.3% and 8.8%, respectively. Vomiting occurred in 6 patients who were given PGE2 but only involved cessation of treatment in 2 cases. All 132 children were normal when discharged from the hospital. The results do not support the assumption that certain patients are more susceptible to PGE2 and others to demoxytocin.