Endocervical prostaglandin E2 gel for preinduction cervical softening.
A single, endocervical application of a new commercial preparation of prostaglandin E2 (PGE2) gel, 0.5 mg of PGE2 in 2.5 ml (3 g), was evaluated for preinduction cervical softening. Safety and efficacy were assessed in a comparison with a 2.0 mg PGE2 vaginal tablet and placebo in normal nulliparous women at term, with low Bishop scores. Treatment was administered in randomized, double blind fashion. Overall success, defined as a progression in Bishop score of at least 3 points within 12 hours, was achieved in 22/40 (55%) of the gel group, 15/41 (37%) in the tablet treated women, and 8/40 (20%) in those receiving placebo. Of interest was the observation that of women with very unfavorable induction features (Bishop score 0-2), the cervical gel treatment resulted in a 6/8 (75%) success rate compared with 2/13 (15%) success for the vaginal tablet and 0/17 (0%) for placebo. In as much as a very low incidence of side effects accompanied this treatment scheme, expanded multi-center testing is recommended.
D000328:Adult; D002584:Cervix Uteri / Q000187:drug effects / Q000502:physiology*; D002986:Clinical Trials as Topic; D015232:Dinoprostone; D005260:Female; D006801:Humans; D007751:Labor, Induced; D010919:Placebos; D011247:Pregnancy; D011458:Prostaglandins E / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D010919:Placebos; D011458:Prostaglandins E; D015232:Dinoprostone