Intracervical PGE2 gel for cervical ripening and induction of Labour

ABSTRACT

The objectives of the study were to evaluate the efficacy of interacervical gel as a cervical ripening agent in the unfavourable cervix. The changes in the Bishops score, onset of labour and its progress were secondary outcome measures. Fifty patients were enrolled in this prospective study conducted in Gynae "A" unit of Khyber Teaching Hospital, Peshawar from January to December 2004. Patients with singleton living fetus, cephalic presentation, gestational age of >36 weeks completed were included. Half milligram [0.5mg] of prostaglandin E2 gel intracervical was used for intracervical application. The application was repeated after 6-12 hours if the Bishop score remained unfavourable i-e < 5. The indications were postdates pregnancy [50%], PIH [18%], Diabetes Mellitus [18%] and Rh isoimmnization [6%]. The success rate in terms of vaginal delivery was 82%. The lower segment caesarean section rate was 18%. The commonest indication for caesarean section was failure to progress. The complications side effects were minimal and the neonatal outcome was good. This study showed that intracervical application of prostaglandin E2 gel is effective, safe acceptable method for ripening of cervix in women with unfavourable cervix