Induction of labor using prostaglandin E2 (PGE2) vaginal gel in triacetin base. An efficacy study comparing two dosage regimens.
OBJECTIVE
To compare two dosage regimens for the administration of vaginal prostaglandin gel in triacetin base for induction of labor.


METHODS
Seventy subjects planned for elective induction of labor at term were randomized to treatment with PGE2 vaginal gel every 6 or 12 hours. The 6-hourly group received an initial dose of 1 mg, followed by 2 mg at 6 hour intervals for a maximum of two additional doses if not in active labor. The 12-hourly group had an initial dose of 2 mg followed by two additional doses at 12 hour intervals if not in active labor.


RESULTS
Successful induction rate was higher in the 12-hourly as compared to 6-hourly gel regimen (100% vs. 91%, P > 0.05). Twelve hours after the initial dose, delivery occurred in 34% delivery had occurred in 57% and 37% respectively (P < 0.01). We found no difference in the induction-active labor interval (P > 0.05), and the induction-delivery interval (P > 0.05) between the two groups. Active labor followed a single dose of gel in 66% of the 12-hourly group compared to 40% of the 6-hourly group (P < 0.01). Syntocinon augmentation was needed in 6% of subjects in the 12-hourly group as compared to 26% in the 6-hourly group (P < 0.01). The cesarean section rate was similar in both groups. Uterine hyperstimulation occurred less frequently in the 12-hourly group (P < 0.05). The perinatal outcome was similar in both groups.


CONCLUSIONS
The 12-hourly regimen was more effective than the 6-hourly regimen in initiating labor. The majority of the subjects in the 12 hourly group achieved labor following a single dose of gel. Induction delivery interval, however, was similar in both groups.
Seeras
R C
RC
Department of Obstetrics and Gynaecology, College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Olatunbosun
O A
OA
Pierson
R A
RA
Turnell
R W
RW
D000328:Adult; D015232:Dinoprostone / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007751:Labor, Induced; D011247:Pregnancy; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D014215:Triacetin / Q000008:administration & dosage*; D014622:Vaginal Creams, Foams, and Jellies
D014622:Vaginal Creams, Foams, and Jellies; D015232:Dinoprostone; D014215:Triacetin