BIOCHEMICAL AND CLINICAL-EVALUATION OF THE EFFICIENCY OF INTRACERVICAL EXTRAAMNIOTIC PROSTAGLANDIN-F2-ALPHA AND INTRAVENOUS OXYTOCIN INFUSION TO INDUCE LABOR AT TERM

A prospective randomized study of 296 patients was undertaken to evalu ate the efficiency of 15 mg prostaglandin F2 is-proportional-to (PGF2 is-proportional-to) suspended in tylose gel and applied intracervicall y for labour induction. The control group was treated with standard ox ytocin intravenous infusion. Results indicated that local PGF2 is-prop ortional-to was superior to oxytocin therapy in shortening the duratio n of labour (6.3 +/- 2.3 versus 8.1 +/- 2.6 hours, p<0.05). Only 19% o f the patients treated with PGF2 is-proportional-to required oxytocin augmentation during labour. Our data suggest that PGF2 is-proportional -to treatment is associated with few maternal side-effects, few failed inductions, a low operative delivery rate and favourable neonatal out come. To investigate the influence of PGF2 is-proportional-to for labo ur promotion we have measured interstitial collagenase and elastase ac tivity in the lower uterine segment after both methods of labour induc tion. The total collagenase activity was 22 times higher in tissue sam ples obtained from patients in active spontaneous and oxytocin-induced labour, compared with women not in labour (at term) (p<0.001). The to tal interstitial elastase activity was 2-fold higher in women in activ e labour than in patients at term (p<0.03). A significantly higher col lagenase and elastase activity was observed in uterine specimens obtai ned from patients treated with PGF2 is-proportional-to compared to oxy tocin, and this indicates that cervical collagen may be digested more quickly in the presence of exogenous prostaglandin F2 is-proportional- to.