Abruptio Placentae 116 Cases: Role of PGE1 in Cervical Ripening and Induction of Labor, January 2006-August 2006

Background: Induction of labor is one of the most important procedures done by the Obstetricians. Induction of labor with the help of prostaglandins offer the advantage of promoting cervical ripening along with stimulating the contractility of the myometrium.Methods: 200 pregnant women with singleton pregnancy both nulliparous and multiparous, were included in the study at term gestation (>39weeks) with Bishop’s score <6, and reactive NST. The subjects were divided in to two groups Group A including patients who were given oral PGE1 - 50 mcg Tab, and Group B with cervical PGE2, 0.5 mg, gel. The outcome indicators were recorded in both Group A and Group B and analyzed. The mean time taken from induction to vaginal delivery in Group A was 628±67 minutes and in Group B was 839±118 minutes. Incidence of LSCS in Group B when compared to Group A (p value <0.005).Results: Incidence of LSCS in Primi’s in Group B compared to Primi’s in Group A was statistically significant (p value 0.009). Non-progression of labor was observed to be the major indication for LSCS in Group B. Meconium stained labor was found to be the major indication for LSCS in Group A.Conclusions: The study concludes that using 50 mcg oral misoprostol, is an effective and safe mode of induction of labor in comparison to PGE2 gel. Vaginal deliveries are more with the use of oral misoprostol and the induction to delivery interval is also lesser than that in cervical PGE2 use.

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Comparative study of misoprostol sublingually and dinoprostone gel intracervically for cervical ripening and induction of labor

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20173497 ◽

2017 ◽

Vol 6 (8) ◽

pp. 3624

Author(s):

Shikha Yadav ◽

Nootan Chandwaskar

Keyword(s):

Mode Of Delivery ◽

Cost Effective ◽

Active Phase ◽

Induction Of Labor ◽

Cervical Ripening ◽

Cost Effective Method ◽

Sublingual Misoprostol ◽

Misoprostol Group ◽

Oxytocin Augmentation ◽

Live Fetus

Background: Both Prostaglandin E1 and E2 analog are being used for cervical ripening. The aims of study was to compare the efficacy and safety profile of sublingual misoprostol (PGE2) and intracervical dinoprostone (PGE1) for cervical ripening and induction of labor.Methods: One hundred women with single live fetus and with gestational age of more than 37 weeks admitted for induction of labor were recruited for the study. Patients were randomized to receive either 25μg of misoprostol sublingually or dinaprostone gel (0.5mg) intracervically.Results: There was shorter induction to active phase, induction to delivery time intervals and less requirement of oxytocin augmentation in misoprostol group than dinoprostone gel group. Incidence of tachysystole was higher in misoprostol group than dinoprostone gel group (22% vs 10%) however this was not statistically significant. Mode of delivery, maternal and neonatal complications were similar in both the groups.Conclusions: Use of misoprostol in lower dose is a safe and cost-effective method for cervical ripening and induction of labor.

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Prostaglandin E2 Cervical Ripening Without Subsequent Induction of Labor

Obstetrics and Gynecology ◽

10.1097/00006250-199907000-00003 ◽

1999 ◽

Vol 94 (1) ◽

pp. 11-14 ◽

Cited By ~ 1

Author(s):

DAVID S. MCKENNA ◽

STEPHANIE W. COSTA ◽

PHILIP SAMUELS

Keyword(s):

Prostaglandin E2 ◽

Induction Of Labor ◽

Cervical Ripening

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Randomized, double-blind trial of prostaglandin E2 intravaginal gel versus low-dose oxytocin for cervical ripening before induction of labor

American Journal of Obstetrics and Gynecology ◽

10.1016/s0002-9378(96)70228-4 ◽

1996 ◽

Vol 174 (6) ◽

pp. 1910-1916 ◽

Cited By ~ 16

Author(s):

Dean M. Pollnow ◽

Fredrik F. Broekhuizen

Keyword(s):

Prostaglandin E2 ◽

Low Dose ◽

Induction Of Labor ◽

Cervical Ripening ◽

Double Blind Trial ◽

Double Blind ◽

Blind Trial

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Induction of labor in patients with an unfavorable cervix after a cesarean using an osmotic dilator versus vaginal prostaglandin

Journal of Perinatal Medicine ◽

10.1515/jpm-2017-0029 ◽

2018 ◽

Vol 46 (3) ◽

pp. 299-307 ◽

Cited By ~ 2

Author(s):

Josefine T. Maier ◽

Melanie Metz ◽

Nina Watermann ◽

Linna Li ◽

Elisabeth Schalinski ◽

...

Keyword(s):

Birth Rate ◽

Induction Of Labor ◽

Cervical Ripening ◽

Exact Test ◽

Safe Delivery ◽

Trial Of Labor ◽

Increased Risk ◽

Chi Squared ◽

Maternal And Neonatal Outcomes ◽

Unfavorable Cervix

Abstract Background: Trial of labor after cesarean (TOLAC) is a viable option for safe delivery. In some cases cervical ripening and subsequent labor induction is necessary. However, the commonly used prostaglandins are not licensed in this subgroup of patients and are associated with an increased risk of uterine rupture. Methods: This cohort study compares maternal and neonatal outcomes of TOLAC in women (n=82) requiring cervical ripening agents (osmotic dilator vs. prostaglandins). The initial Bishop scores (BSs) were 2 (0–5) and 3 (0–5) (osmotic dilator and prostaglandin group, respectively). In this retrospective analysis, Fisher’s exact test, the Kruskal-Wallis rank sum test and Pearson’s chi-squared test were utilized. Results: Vaginal birth rate (including operative delivery) was 55% (18/33) in the osmotic dilator group vs. 51% (25/49) in the dinoprostone group (P 0.886). Between 97% and 92% (32/33 and 45/49) (100%, 100%) of neonates had an Apgar score of >8 after 1 min (5, 10 min, respectively). The time between administration of the agent and onset of labor was 36 and 17.1 h (mean, Dilapan-S® group, dinoprostone group, respectively). Time from onset of labor to delivery was similar in both groups with 4.4 and 4.9 h (mean, Dilapan-S® group, dinoprostone group, respectively). Patients receiving cervical ripening with Dilapan-S® required oxytocin in 97% (32/33) of cases. Some patients presented with spontaneous onset of labor, mostly in the dinoprostone group (24/49, 49%). Amniotomy was performed in 64% and 49% (21/33 and 24/49) of cases (Dilapan-S® group and dinoprostone group, respectively). Conclusions: This pilot study examines the application of an osmotic dilator for cervical ripening to promote vaginal delivery in women who previously delivered via cesarean section. In our experience, the osmotic dilator gives obstetricians a chance to perform induction of labor in these women.

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