Randomized trial of vaginal prostaglandin E2 versus oxytocin for labor induction in term premature rupture of membranes.
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.
Kunt
Cigdem
C
Department of Perinatology, Dr Zekai Tahir Burak Women Health Research and Education Hospital, Ankara, Turkey.
Kanat-Pektas
Mine
M
Gungor
Ayse Nur Cakir
AN
Kurt
Raziye Keskin
RK
Ozat
Mustafa
M
Gulerman
Cavidan
C
Gungor
Tayfun
T
Mollamahmutoglu
Leyla
L
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
D010120:Oxytocics; D010121:Oxytocin; D015232:Dinoprostone