title: Randomized trial of vaginal prostaglandin E2 versus oxytocin for labor induction in term premature rupture of membranes.
abstract: OBJECTIVE
  The aim of this study was to compare the efficacy and safety of a prostaglandin E(2) (PGE(2)) vaginal insert with those of oxytocin for labor induction. The present study also examined whether its use reduces the rate of cesarean delivery in term pregnancies with premature rupture of membranes (PROM) and low Bishop scores.
  
  
  METHODS
  A total of 240 women with singleton pregnancies at >or= 37 weeks, no prior uterine scar, vertex presentations, reactive nonstress tests, PROM for >or= 12 hours and Bishop scores of <or= 6 were randomly assigned to receive either oxytocin or vaginal PGE(2). The primary outcomes were time from induction to delivery and mode of delivery.
  
  
  RESULTS
  The time from labor induction to active labor onset was significantly shorter in the oxytocin group than in the PGE(2) group (4.9 +/- 4.1 vs. 8.5 +/- 3.6 hours; p = 0.02). The time from induction to delivery was also significantly shorter in the oxytocin group (3.4 +/- 1.5 vs. 9.6 +/- 4.7 hours; p = 0.02). Cesarean delivery rates were statistically similar in the oxytocin and PGE(2) groups (18.3 vs. 20.0%; p = 0.81). Neonatal outcomes were comparable in both groups. Comparable results were observed for nulliparous women included in the study population.
  
  
  CONCLUSIONS
  Oxytocin treatment seems to be superior to vaginal administration of PGE(2) to induce labor in term pregnancies complicated with PROM and unfavorable services.
authors.affiliation: Department of Perinatology, Dr Zekai Tahir Burak Women Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Kunt
authors.forename: Mine
authors.initials: M
authors.lastname: Kanat-Pektas
authors.forename: Ayse Nur Cakir
authors.initials: AN
authors.lastname: Gungor
authors.forename: Raziye Keskin
authors.initials: RK
authors.lastname: Kurt
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozat
authors.forename: Cavidan
authors.initials: C
authors.lastname: Gulerman
authors.forename: Tayfun
authors.initials: T
authors.lastname: Gungor
authors.forename: Leyla
authors.initials: L
authors.lastname: Mollamahmutoglu
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D015232:Dinoprostone / Q000627:therapeutic use*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000379:methods*; D007743:Labor, Obstetric; D010120:Oxytocics / Q000627:therapeutic use*; D010121:Oxytocin / Q000627:therapeutic use*; D011247:Pregnancy; D013997:Time Factors
chemical_list: D010120:Oxytocics; D010121:Oxytocin; D015232:Dinoprostone