Prostaglandin E2 gel for cervical priming and induction of labour in unfavourable cervical state.

ABSTRACT

To know the safety and efficacy of intracervical prostaglandin E2 gel over conventional intravenous infusion of oxytocin for priming and induction of labour, a prospective study was undertaken in 96 cases selected at random for both study and control series consisting 48 cases in each group with definite indication for termination of pregnancy having unfavourable cervical state. Periodic clinical assessment in different groups following the procedure revealed that by the end of 12 hours, 39 cases in the study and 28 cases in the control group had uterine contraction. Foetal heart rate abnormality was more marked in the oxytocin group (1.56% in the study group and 20.31% in the control group) while increase in Bishop's cervical scoring was noticed more often in the prostaglandin group. By the end of 12 hours of initiation of therapy, 17 cases in the study group and only 3 cases in the control group had spontaneous vaginal delivery. There was significant shortening of instillation and delivery interval in PGE2 group. The number of caesarean section in the study group was only 16.66% in comparison to 25% in the control group. Analysing the efficacy of the procedures adopted, the success rate in the prostaglandin group was 91.66% in contrast to 64.58% in the oxytocin group.