COST IMPLICATIONS IN THE MANAGEMENT OF INDUCTION OF LABOR

For many years the standard treatment of induction of labour has been amniotomy followed by intravenous oxytocin. More recently prostaglandi n E-2 (PGE(2); dinoprostone), in various preparations, has been used t o both ripen the cervix before amniotomy and administration of oxytoci n, and to induce labour on its own. Since the acquisition cost of PGE( 2) is approximately 15 times that of oxytocin, it is important to just ify the use of PGE(2). In this paper, literature from 1970 to 1996 has been reviewed and outcomes following the use of PGE(2) plus amniotomy and oxytocin if necessary, have been compared with outcomes following the use of amniotomy plus oxytocin alone. No significant differences in the mode of delivery and no serious adverse effects in mothers or b abies were detected. Three economic analyses of these approaches to in duction of labour have been reviewed, While under certain conditions t here may be some cost savings associated with the use of PGE(2), neith er of the studies reviewed showed substantial, reliable cost savings. Further research is required to identify, the patients who would gain most benefit from the use of PGE(2).