Double-blind comparison of intravaginal prostaglandin E2 gel and “chip” for preinduction cervical ripening

Impact of prolonged dinoprostone cervical ripening on the rate of artificial induction of labor: A prospective study of 330 patients

“…Rates reported in the literature vary depending on the molecule used, its dose, and route of administration. The use of the vaginal devices induces hyperstimulation from 0% to 21%, depending on the study . The rates obtained in our study are consistent (8.1%).…”

“…The use of the vaginal devices induces hyperstimulation from 0% to 21%, depending on the study. [21][22][23][24][25][26][27] The rates obtained in our study are consistent (8.1%). Hyperstimulation was associated with FHR abnormalities in less than 50% of cases, and always resolved upon removal of the vaginal insert.…”

Efficacy and safety of a 2-tier prostaglandin labor induction schedule

“…However in our opinion, this merely confirms the unfavourable cervical status represented by a low Bishop score and provides no grounds for modifying the present schedule, particularly as there are studies showing that with an unripe cervix PGE 2 tablets increase adverse uterine events and fetal acidosis more than does the gel [19]. Mahmood [13] too points out that the secondary section rate is particularly high (30%) when PGE 2 tablets are used to induce women with an unripe cervix.…”

“…As a general rule, any substance used for induction must carry the lowest possible risk to the fetus. Studies to date show that PGE 2 gel is preferable to the tablet formulation in women with an unripe Bishop score < 5 [19], spontaneous delivery following within 24 h in some 2/3 of cases. Oxytocin, on the other hand, in the presence of an unripe cervix, results in vaginal delivery in only 1/3 of cases [12].…”

“…Die Geburtseinleitung mit PGE 2 führte in 76,9% zur Spontangeburt. 281/467 Schwangere wiesen vor der Einleitung einen mittelreifen Bishop-Score (= 5-7) auf und wurden mit PGE 2 (19,4 contre 10,7%), delivrance vaginale operatoire (11,3 contre 7,5%), acidose fostale (8,1 contre 2,6%). L'instillation repetee de gel de PGE 2 n'accroit pas de maniere sensible la frequence de ces trois reactions intempestives.…”