title: Prostaglandin E2 vaginal gel or tablets for the induction of labour at term: a randomised controlled trial.
abstract: OBJECTIVE
  To compare the effectiveness of prostaglandin E2 (dinopristone) vaginal gel versus vaginal tablets for the induction of labour at term.
  
  
  METHODS
  Randomised controlled clinical trial.
  
  
  METHODS
  University maternity hospital in London.
  
  
  METHODS
  Pregnant women with cephalic presentation undergoing induction of labour after 37 weeks of gestation.
  
  
  METHODS
  Prostaglandin E2 vaginal tablets (3 mg) or vaginal gel (1 mg/ 2 mg) was administered at 6-hourly intervals until the cervix was suitable for amniotomy.
  
  
  METHODS
  Induction to delivery interval, in minutes; rate of failed induction of labour requiring caesarean delivery.
  
  
  RESULTS
  Eighty-two women received prostaglandin gel; 83 women received vaginal tablets. There were significant differences between the two treatment groups in the primary outcomes. The mean induction to delivery interval was significantly shorter in women who received the gel (1400 minutes, 690-2280 minutes, versus 1780 minutes, 960-2640 minutes; P = 0.03). The rate of failed induction of labour was significantly higher in women who received tablets (10.84 versus 1.22%; P = 0.01). Subanalysis showed that these differences were only representative of differences in the groups of primigravid women. There were no significant differences in any of the secondary outcomes, including the number of women who required syntocinon augmentation, the rate of uterine hyperstimulation, the need for epidural analgesia, meconium staining of liquor, the need for fetal blood sampling, or delivery by caesarean section. There were no differences in adverse maternal and neonatal outcomes.
  
  
  CONCLUSIONS
  Prostaglandin E2 vaginal gel is superior to vaginal tablets for the induction of labour.
authors.affiliation: Queen Charlotte's and Chelsea Hospital, Imperial Healthcare NHS Trust and Imperial College London, London, UK.
authors.forename: S E
authors.initials: SE
authors.lastname: Taher
authors.forename: J W
authors.initials: JW
authors.lastname: Inder
authors.forename: S A
authors.initials: SA
authors.lastname: Soltan
authors.forename: J
authors.initials: J
authors.lastname: Eliahoo
authors.forename: D K
authors.initials: DK
authors.lastname: Edmonds
authors.forename: P R
authors.initials: PR
authors.lastname: Bennett
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D015232:Dinoprostone; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D007744:Obstetric Labor Complications / Q000209:etiology; D010120:Oxytocics; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D013607:Tablets; D047929:Term Birth; D014622:Vaginal Creams, Foams, and Jellies
chemical_list: D010120:Oxytocics; D013607:Tablets; D014622:Vaginal Creams, Foams, and Jellies; D015232:Dinoprostone