CERVICAL RIPENING WITH INTRAVAGINAL PROSTAGLANDIN-E2 GEL

Abstract

Ripening of the cervix by intravaginal application of a prostaglandin[PG]-containing gel is evaluated. Thirty patients with an unfavorable cervix needing labor induction were studied in a double-blind, prospective fashion. The PG gel proved superior to placebo in ripening the cervix (P < 0.05), reducing induction failures (P < 0.025), diminishing the oxytocin dosage necessary for induction (P < 0.05), and lowering the rate of cesarean section (0.05 < P < 0.1). An additional 150 patients with varying Bishop scores and differing clinical situations were also studied. There were 35 cesarean sections (23.3%), 9 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 2.5 mg of PG E2. Average Bishop score change was 2.9, and there was a 55% incidence of spontaneous labor.