ANTEPARTUM CERVICAL RIPENING - APPLYING PROSTAGLANDIN E-2 GEL IN CONJUNCTION WITH SCHEDULED NONSTRESS TESTS IN POSTDATE PREGNANCIES

OBJECTIVE: Our purpose was to evaluate whether inserting prostaglandin E-2 gel at the time of scheduled nonstress tests in patients with pos tdate pregnancies can decrease rates of intervention. STUDY DESIGN: A multicenter pilot study enrolled women with postdate pregnancies with Bishop score less than or equal to 6 who were undergoing antepartum fe tal heart rate testing. Patients were randomized in a double-blind fas hion to receive either a prostaglandin E-2 intracervical gel (Prepidil ) or a placebo gel after each of their scheduled nonstress tests. RESU LTS: There were no significant differences in the number of antepartum tests, labor inductions, or cesarean sections, the maximum oxytocin d osage, or the interval from admission to delivery in the prostaglandin E-2 gel and placebo gel groups (n = 90). In the subset of patients wi th a Bishop score between 3 and 6 (63 patients), there were fewer indu ctions in the prostaglandin E-2 group (30% vs 55%, P <.05). CONCLUSION : Application of prostaglandin Ee gel at the time of scheduled antepar tum testing in patients with postdate pregnancies with unfavorable cer vices decreased the induction rate only among patients with intermedia te Bishop scores.