title: Safety of labor induction with prostaglandin E2 in grandmultiparous women.
abstract: OBJECTIVE
  The aim of this study was to assess the safety of labor induction with vaginal prostaglandin E2 (PGE2) in grandmultiparous women.
  
  
  METHODS
  We conducted a retrospective cohort study of 1376 grandmultiparous women who underwent induction of labor with low dose PGE2. The primary outcome was uterine rupture and secondary outcomes included mode of delivery, postpartum hemorrhage and five minutes Apgar score.
  
  
  RESULTS
  One case was diagnosed with uterine rupture (0.07%). Vaginal delivery was achieved in 1329 (96.6%) patients, whereas 47 (3.4%) patients had emergent cesarean delivery. Five minutes Apgar score ≤7 was recorded in three cases (0.2%). There was no correlation between parity and cesarean delivery rate or low Apgar score. There were no significant differences between the grandmultiparous and great-grandmultiparous patients regarding cesarean delivery rate (3.1 vs. 5%, P = 0.12), operative vaginal delivery rate (2 vs. 2.3%, P = 0.74) or postpartum hemorrhage rate (0.8 vs. 1.1%, P = 0.6).
  
  
  CONCLUSIONS
  Low dose PGE2 is a safe and efficient method for induction of labor in grandmultiparous and great-grandmultiparous women.
authors.affiliation: Department of Obstetrics and Gynecology , Mayanei-Hayeshua medical center, Bnei-Brak , Israel. jigalh@hotmail.com
authors.forename: Jigal
authors.initials: J
authors.lastname: Haas
authors.forename: Eran
authors.initials: E
authors.lastname: Barzilay
authors.forename: Benny
authors.initials: B
authors.lastname: Chayen
authors.forename: Oshrit
authors.initials: O
authors.lastname: Lebovitz
authors.forename: Yoav
authors.initials: Y
authors.lastname: Yinon
authors.forename: Israel
authors.initials: I
authors.lastname: Hendler
authors.forename: Linda
authors.initials: L
authors.lastname: Harel
mesh_terms: D000328:Adult; D015232:Dinoprostone / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D008875:Middle Aged; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D010120:Oxytocics; D015232:Dinoprostone