Cervical ripening by extra-amniotic normal saline instillation versus prostaglandin - E2 vaginal tablets

ABSTRACT

Seventy-five pregnant patients with unripe cervix [Bishop score < /= 4] were randomly subjected to two treatment protocols for cervical ripening. Group A consisted of 40 pregnant women managed by extra-amniotic saline instillation at a rate of 1 ml/minute. Group B consisted of 35 pregnant women who received prostaglandin-E2[3mg] vaginal tablets. Cervical ripening occured over a significantly shorter mean duration among group A [4.04 +/- 1.29 hours] compared to group B [7.78 +/- 2.64 hours] [P < 0,01]. Mean post-ripening Bishop score was significantly higher in group A [7.07 +/- 0.38] compared to group B [5. 2 +/- 0.77] [P < 0.01]. Oxytocin stimulation was more frequently required [P < 0.05] and at a significantly nigher mean dose [< 0.05] following cervical ripening with extraamniotic saline instillation. A significantly longer mean total induction-delivery time [P < 0.05] and a significantly higher incidence of uterine hyperstimulation and abnormal FHR tracing [P < 0.01] were encountered among the prostaglandin-treated group. There was no significant difference between the two groups regarding the mode of delivery and the neonatal condition at birth [P > 0.05]. No serious side effects were registered in either group. Thus, extra-amniotic saline instillation may be considered as a cheap, effective, safe and tolerable method of cervical ripening that is always available