Cervical ripening with intravaginal prostaglandins E2 gel

ABSTRACT

Ripening of the cervix by intravaginal application of a prostaglandin containing gel was evaluated. Thirty patients with an unfavorable cervix needing labor induction were studied in a double-blind prospective fashion. The prostaglandin gel proved superior to placebo in ripening the cervix [p<0.5], reducing induction failure [p<0.25] diminishing the oxytocin dosage necessary for induction [p<0.5]. and lowering the rate of cesarean section [p<0.1]. One hundred fifty additional patients with varying Bishop scores and differing clinical situation were also studied. There were 35 cesarean sections [23.3%], nine failed inductions [6%], a spontaneous labor rate of 46% and an average Bishop score change of 2.5. Twenty patients with premature rupture of the membranes and an unfavorable cervix received a modified gel containing 2.5mg of prostaglandin E2. Average Bishop score change was 2.9, and there was 55% incidence of spontaneous labor