The experience with prostaglandin E2 vaginal tablets for induction of labour in grand and great grand multiparae. A two year review in Saudi Arabia.
In an attempt to review our experience with prostaglandin E2 vaginal tablets in induction of labour in grandmultiparae (parity 5-9) and great grandmultiparae (parity > 9) a retrospective study was carried out at King Faisal Military Hospital in Saudi Arabia over a 2-year period. An evaluation of our protocol for induction of labour using prostaglandin in these groups of patients was also made. The patients included 271 grandmultiparae and 63 great grandmultiparae. There were no serious side effects in our series referable to the prostaglandin induction. There were no significant differences in the two groups regarding the mean total dose of prostaglandin used, mean length of second stage of labour, mean birth weight and admission to the neonatal intensive care unit (P > 0.05). However, the need for syntocinon augmentation was more in the great grandmultiparae (29% vs. 19%) but this was not significant statistically (P = 0.64). The caesarean section rate was higher in the great grandmultiparae (14% vs.10%) but not statistically significant (P = 0.19). None of the babies in the study group had an Apgar score less than 7 at 5 minutes. This study has shown that it may be safe to use prostaglandin E2 vaginal tablets for induction of labour in grandmultiparae and great grandmultiparae in our environment although the sample size may not be large enough to draw definite conclusions. Our protocol of stepwise increase in prostaglandin dose did not increase maternal or fetal morbidity but might actually have reduced the number of caesarean sections performed and therefore maternal mortality associated with caesarean section in the grandmultiparae. A multicentre prospective trial is eagerly awaited.
Al Bar
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H
Department of Obstetrics and Gynaecology, College of Medicine, King Saud University, Abha, Kingdom of Saudi Arabia.
Sobande
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A
Hussein
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O
Thiga
R
R
Mushait
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M