The use of low dose 1.5 mg prostaglandin E2 gel for cervical ripening and induction of labor at term with unfavorable cervix.

ABSTRACT

A prospective study was undertaken to evaluate the efficacy and safety of a 1.5 mg prostaglandin E2 gel applied intracervically for the initiation of cervical ripening before the induction of labor. All patients were required to have an initial Bishop score of four or less. There was a total of 220 pregnant women in this study and primipara accounted for 175 or 80 per cent of the pregnant women. The 1.5 mg PGE2 gel was found to be an effective means of cervical ripening in both primipara and multipara with a success rate of 77.7 and 93.3 per cent after the first application to 96 and 100 per cent in the second application, respectively. The mean induction to delivery time was 25.17 hours in primipara and 13.57 hours in multipara. The mean amniotomy to delivery time was 7.55 and 4.65 hours in primipara and multipara, respectively. The cesarean section rate was 48 per cent and 18 per cent in primipara and multipara, respectively. The side-effects were minimal. These results compare well with other reported studies using different dosages and routes.