VAGINAL AND INTRACERVICAL PROSTAGLANDIN E(2) FOR CERVICAL RIPENING - A DOPPLER STUDY OF HEMODYNAMIC-EFFECTS

The hemodynamic effects of vaginally and intracervically administered prostaglandin E(2) gel were evaluated by pulsed wave color Doppler ult rasound. Twenty term pregnant mothers were recruited. Mothers were ran domized to receive either vaginal or intracervical prostaglandin E(2) gel. The hemodynamics were assessed by repeated color Doppler velocime try of the uterine artery and fetal umbilical and middle cerebral arte ries; analysis of variance was used to test statistical significance. In the uterine artery a statistically significant rise (P less than or equal to 0.001) of the pulsatility index (PI) was observed. A slightl y higher rise of the PI was observed after intracervical administratio n, but the difference between the groups was not statistically signifi cant (P = 0.4). The fetal PI remained unchanged both in the umbilical and cerebral vessels throughout the study. The rise in the uterine art ery PI is probably caused by an increase in the uterine tone as prosta glandins of the E series usually cause vasodilation. No detectable fet al effects were evident.