Induction of labor with intravaginal prostaglandin E2 gel.
OBJECTIVE
The aim of our study was to evaluate the optimum dose of intravaginal prostaglandin E2 gel for induction for labor in nulliparous women with a relatively ripe cervix (modified Bishop score 4 or 5).


METHODS
One hundred and sixty-seven nulliparous women at term with indications 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 PGE2 gel every 12 h. Data were analyzed by chi 2-test and Student's t-test.


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 women 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).


CONCLUSIONS
The vaginal administration 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.
Norchi
S
S
Department of Obstetrics and Gynecology Valduce Hospital, Como, Italy.
Zanini
A
A
Ragusa
A
A
Maccario
L
L
Valle
A
A
D000282:Administration, Intravaginal; D000328:Adult; D000650:Amnion / Q000601:surgery; D015232:Dinoprostone / Q000008:administration & dosage*; D005260:Female; D005782:Gels; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies
D005782:Gels; D015232:Dinoprostone