COMPARISON OF INTRAVAGINAL AN 2 INTRACERVICAL PROSTAGLANDIN-E2 GELS IN PREINDUCTION OF LABOR

A randomized study was undertaken to compare the effect of vaginal (1 mg of dinoprostone/2.5 ml gel) and intracervical (0.5 mg of dinoprosto ne in 2.5 ml of two different vehicles) on induction of labor and peri natal outcome. Sixty women (n = 20/20/20) who presented with an unfavo rable cervix and a specific indication for the induction of labor part icipated in the study. There were no significant differences between t he groups with respect to maternal age, weight, parity, gestational le ngth or Bishop scores before prostaglandin E2 preinduction. Labour was induced with prostaglandin gel alone in twenty-two patients and with oxytocin infusion on the following morning after gel application in se ven patients; altogether the rate of succesful induction was 48.3 %. T he rate of uterine hyperstimulation was 16.7 % with most cases in the groups receiving intracervical prostaglandin E2. Neonatal asphyxia dia gnosed with umbilical vein and artery blood gas analysis was seen in e leven neonates who were delivered by labor induced with prostaglandin gel alone (50 %). Prostaglandin pre-induction decreases the need for C esarean sections in complicated pregnancies, but because of the risk o f uterine hyperstimulation and neonatal asphyxia prostaglandins should be used only with specific indications.