Extra-amniotic saline infusion versus extra-amniotic prostaglandin F-2 alpha for cervical ripening and induction of labor

Objective: To compare the effectiveness of extra-amniotic saline infusion v ersus extra-amniotic prostaglandin F(2)alpha for cervical ripening, inducti on of labor and achievement of vaginal delivery in patients with unfavorabl e cervices. Method: A randomized trial of extra-amniotic saline infusion ve rsus extra-amniotic prostaglandin F(2)alpha performed at Harare Central Hos pital Maternity Unit, Zimbabwe. One hundred and sixty-four patients were re cruited from those referred to Harare Central Hospital Maternity Unit who r equired induction of labor for either maternal or fetal indications. Result s: 162 patients (extra-amniotic PgF(2) alpha group, N = 81; extra-amniotic saline infusion group, N = 81) had complete information. Two patients tone from each group) were lost to follow up. The demographic characteristics of the patients and the indications for induction were not statistically diff erent. There was a marginally statistically significant difference in the c hange of Bishop Score in favor of the extra-amniotic saline infusion (4.0, S.D. = 1.4) as compared to (4.5, S.D. = 1.5) for extra-amniotic PgF(2) alph a (P value = 0.047). All other parameters showed no statistically significa nt differences. Maternal and fetal complications were minimal and not signi ficantly different. Extra-amniotic saline infusion was however almost six t imes cheaper than PgF(2) alpha. Conclusion: Extra-amniotic saline infusion is as effective as PgF(2) alpha, safe, but much cheaper than PgF(2) alpha a nd should be seriously considered as a method of first choice in resource-p oor settings. (C) 1999 International Federation of Gynecology and Obstetric s.