Cervical ripening and induction of labor by intracervical and extra-amniotic prostaglandin gel application in cases of intrauterine fetal death.
In 42 patients with intrauterine fetal death between the 29th and 43rd week of gestation, a standard, 2-step procedure was employed to deliver the dead fetus. After priming with an intracervical application of PGF2 alpha- or PGE2-gel, labor was induced by extra-amniotic prostaglandin (PG) gel or oxytocin infusion while under epidural anesthesia. Intracervical PG application led to a significant improvement in the modified Bishop score from 1.3 to 7.6 after a mean of 8 h. In 20 patients labor and progressive dilatation of the cervix occurred after intracervical PG gel application alone. The average total therapy time was 18.1 h in patients treated with PGF2 alpha and 13.7 h in the PGE2-treated group. The average induction of labor to delivery intervals were 8.8 h in the PGF2 alpha- and 7.1 h in the PGE2-group. Gastrointestinal side effects were observed in only 5 patients. The combination of cervical ripening with intracervical PG gel application and induction of labor by extra-amniotic PG gel under epidural anesthesia is an efficient and safe method for treatment of intrauterine fetal death.
Rath
W
W
Kuhn
W
W
D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000187:drug effects*; D015237:Dinoprost; D015232:Dinoprostone; D005260:Female; D005313:Fetal Death; D005782:Gels; D006801:Humans; D007751:Labor, Induced; D011247:Pregnancy; D011453:Prostaglandins / Q000008:administration & dosage / Q000494:pharmacology*; D011458:Prostaglandins E / Q000008:administration & dosage / Q000494:pharmacology; D011460:Prostaglandins F / Q000008:administration & dosage / Q000494:pharmacology; D013997:Time Factors
D005782:Gels; D011453:Prostaglandins; D011458:Prostaglandins E; D011460:Prostaglandins F; D015237:Dinoprost; D015232:Dinoprostone