USE OF CERVICAL PROSTAGLANDIN E(2) GEL IN PATIENTS WITH PREVIOUS CESAREAN-SECTION

The aim of this study was to determine whether preinduction cervical r ipening with prostaglandin E(2) (PgE(2)) gel in patients with one prev ious cesarean section may be used with the same safety and efficacy as in patients without a uterine scar. Primiparous patients (n = 94) wit h one previous cesarean section were retrospectively compared to nulli parous patients (n = 866). Both groups underwent preinduction cervical ripening with 2 mg intracervical PgE(2) gel. Logistic regression was performed to control for confounding factors. Our statistical power wa s 90% for detecting a doubling of the complication rate, from 10 to 20 %. There were no significant differences in the duration of ruptured m embranes or length of labor between the two groups. No significant dif ferences were detected in the rate or indications for cesarean section , presence of thick meconium, epidural anesthesia use, amnionitis, or maternal and neonatal morbidity. There were no cases of uterine ruptur e in either group. PgE(2) gel may be used with the same safety and eff icacy in patients with previous cesarean section as in nulliparas.