With the participation of four Swiss obstetric clinics, medically indicated inductions of birth (with living fetuses) were performed using a new, stable PGE2 gel, and documented according to a uniform protocol. The study was conducted to investigate the efficacy of 0.5 mg of PGE2, in 2.5 ml of a vehicle (Triacetin) not yet commercially available, for local cervical maturation (n = 41). Thirty-nine patients selected by prospective randomization, in whom birth was induced conventionally, served as a control group. The efficiency of the prostaglandin gel alone or respectively with additional administration of oxytocin was evaluated on the basis of the clear changes in the cervical findings observed within 12 or respectively 24 hours, the spontaneous births, or, in the case of cesarean deliveries, according to the pelvic score. Application of PGE2 alone led to impressive changes of the cervix score and, in 34 of the 41 cases, to regular contractions after an average time of 87 minutes. After 12 hours, prior to administration of oxytocin, 43% of the patients were already delivered. The combination of locally applied PGE2 gel with conventional oxytocin induction significantly increases the number of successful inductions. The percentage of unsuccessfully attempted inductions was reduced to 24% in the PGE2 gel group as compared to 44% in the control group.

und der Rate gastrointestinaler Nebenwirkungen zeigte sich eine eindeutige Abhangigkeit vonder verabreichten Sulproston-Dosis. Die Applikation des neuartigen Sulproston-Gelgemisches ist eine praktikable und einfach zu handhabende Methode zum pr~ioperativen Zervixpriming. Da das Gelgemisch erst kurz vor dem Gebrauch hergestellt wird, ist eine Kontamination mit Bakterien nicht zu beftirchten; ebenso kann wegen der schnellen Anwendung der frisch zubereiteten Sol/Gelpr~iparation ein Wirkverlust ausgeschlossen werden. Nach ersten Erfahrungen dtirfte unter Beriacksichtigung der Effizienz und der Rate unerwtinschter Begleitwirkungen die 50 ~tg-Dosierung zu empfehlen sein. Uber erste Erfahrungen mit einem neuen intracervical anwendbaren Prostaglandin-E2-Gel zur Geburtseinleitung