EFFECTS OF INTRACERVICAL PROSTAGLANDIN E(2) ON FETAL HEART-RATE AND UTERINE ACTIVITY PATTERNS IN THE PRESENCE OF OLIGOHYDRAMNIOS

OBJECTIVE: Our purpose was to compare fetal heart rate patterns and ut erine activity before and after preinduction prostaglandin E(2) admini stration in the presence or absence of oligohydramnios. STUDY DESIGN: In a retrospective case-controlled review we examined cases in which p rostaglandin E(2) (Prepidil) was inserted intracervically for gravid w omen requiring an induction of labor in the presence of either oligohy dramnios (amniotic fluid index less than or equal to 5.0) or adequate fluid (amniotic fluid index 5.1 to 23.9). Uterine activity and fetal h eart rate tracings that were begun 1 hour before and continued for 6 h ours after dosing were interpreted without knowledge of amniotic fluid volume. RESULTS: Cases in the olgiohydramnios (n = 51) and adequate f luid (n = 49) groups were the same for maternal age, race, parity, ges tational age, and predose Bishop score. Patients with oligohydramnios had more high-amplitude contractions in the first hour after dosing (9 .0 +/- 1.2 vs 6.1 +/- 0.9, p < 0.05), but there were no significant di fferences in the frequency or duration of contractions during the subs equent 5 hours. Uterine hyperstimulation was not seen, and there were no differences in the frequency of variable or late fetal heart rate d ecelerations. CONCLUSION: For pregnancies undergoing preinduction cerv ical ripening with intracervical prostaglandin E(2), the presence of o ligohydramnios was not associated with a greater risk of fetal heart r ate decelerations, although contractions were more common during the f irst hour after dosing.