S. Norchi et al., INDUCTION OF LABOR WITH INTRAVAGINAL PROSTAGLANDIN-E(2) GEL, International journal of gynaecology and obstetrics, 42(2), 1993, pp. 103-107
OBJECTIVE: The aim of our study was to evaluate the optimum dose of in
travaginal prostaglandin E2 gel for induction of labor in nulliparous
women with a relatively ripe cervix (modified Bishop score 4 or 5). ME
THOD: One hundred and sixty-seven nulliparous women at term with indic
ations for the induction of labor were treated randomly with two doses
of intravaginal 2.0 (group A) or 3.0 mg (group B) of prostaglandin PG
E2 gel every 12 h. Data were analyzed by chi2-test and Student's t-tes
t. RESULTS: Of 87 patients 64 went into labor after gel application in
group A, compared with 68/80 in group B (73.5% vs. 85.0%) (P = NS). A
second gel administration was needed for 9 women in group A and 6 wom
en in group B. More side effects (both local and systemic) were noted
in group B than in group A (28.7% vs. 14.9%) (P = 0.03). In particular
, more local (hyperstimulation or hypertonus) side effects were noted
in group B (13.7% vs. 2.3%) (P = 0.01). CONCLUSION: The vaginal admini
stration of 2.0 mg of PGE2 gel seems to be equally effective as 3.0 mg
in terms of labor success rate with a significant lower incidence of
side effects.