Induction of labor with intravaginal prostaglandin E<sub>2</sub>gel

Norchi, S.; Zanini, Alberto; Ragusa, Antonio; Maccario, L; Valle, Alfonso Del

doi:10.1016/0020-7292(93)90621-3

Cited by 14 publications

(3 citation statements)

References 10 publications

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“…Intravaginal PGE 2 has been shown to induce labor in patients with any degree of cervical ripeness, with dosages of 1 mg needed to accomplish active labor in the multiparous patient with a Bishop score of 8-9, compared to dosages of 3 mg in the nulliparous patient with a Bishop score of 5-6 [6]. In the nulliparous patient with a relatively ripe cervix, 2 mg intravaginal PGE 2 results in fewer side effects such as uterine hypertonus, uterine hyperstimulation, and fetal bradycardia, than a 3-mg dosage, 2.3% vs. 8.7%, respectively [5]. The safety of intravaginal PGE 2 , at dosages less than 3 mg has been extensively evaluated.…”

Section: Recent Reports From the National Institute Of Childmentioning

confidence: 95%

“…Paramount amongst these less conventional techniques are 1) use of intravaginal prostaglandin E 2 (PGE 2 ) for labor induction with an unfavorable cervix, rather than preinduction cervical ripening [3,4]; 2) use of intravaginal PGE 2 for labor induction with a favorable cervix [5][6][7], rather than oxytocin and amniotomy; 3) outpatient, rather than inhospital, administration of intravaginal PGE 2 to ripen the cervix and induce labor [8][9][10], while simultaneously performing antenatal fetal testing; and 4) use of membrane stripping, after intravaginal PGE 2 tablet administration, to enhance labor induction [6].…”

Section: Introductionmentioning

confidence: 99%

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Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping

Doany¹,

McCarty²

1997

J. Matern. Fetal Med.

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The purpose of the study was to determine the safety and efficacy of outpatient intravaginal prostaglandin E 2 (PGE 2 ) and membrane stripping in promoting labor in the uncomplicated postdate pregnancy. In a double-blind placebo-controlled study, 150 enrollees were randomized to one of four treatment groups: group I, no membrane stripping and placebo gel; group II, no membrane stripping and PGE 2 gel; group III, membrane stripping and placebo gel; and group IV, membrane stripping and PGE 2 gel. The treatments were administered at 287 days (41 weeks) and 294 days (42 weeks) of gestation, then every 3-4 days until 307 days (43 completed weeks) of gestation. The patients in group IV had the shortest interval to delivery with a median of 1 day, P 5 .001, and had the fewest antenatal surveillance visits with only 21% requiring more than one visit, P 5 .02. Group I patients in comparison, had a 7-day median to delivery, and 61% required more than one visit. The time spent in labor and delivery and the need for oxytocin augmentation was not significantly reduced in groups II, III, and IV. No adverse side effects to either mother or neonate could be directly attributed to this outpatient treatment combination. We conclude that intravaginal PGE 2 gel combined with membrane stripping reduces postterm pregnancies and antenatal visits in our patients.

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Section: Recent Reports From the National Institute Of Childmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping

Doany¹,

McCarty²

1997

J. Matern. Fetal Med.

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“…Intra cervical Foley catheter act as a mechanical dilator of the cervix and the lower segment of the uterus and it indirectly induces localized secretion of prostaglandin due to activated acute inflammation 6,7,8,11 . Foley catheter is less costly in compared to PGE 2 intracervical gel and there is no increased risk of infection as well.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of extra amniotic insertion of Foley catheter verses intra cervical application of PGE2 gel in pre-induction cervical ripening among primi mothers at 40 weeks +5 days or beyond – a randomized controlled study

Gunawardena¹,

Kumbukage

Gunawardena

et al. 2020

Sri Lanka J Obstet & Gynae

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Objectives: The aim of this study was to compare the efficacy, safety and side effects of extra amniotic insertion of Foley catheter and intra-cervical application of prostaglandin E 2 vaginal gel (PGE 2) among primi mothers who were 40 weeks or beyond, as a pre induction ripening method. Method: This randomized study was conducted at Obstetrics ward, Kandy Teaching Hospital, between August 2010 to March 2011. Hundred and fourty-five mothers were randomly allocated to two groups. Age, BMI, period of gestation and, pre ripening Bishop's score were measured as base line features to compare two groups. Group A (n=72) was ripened with prostaglandin E 2 vaginal gel (Dinoprostone 0.5 mg) and Group B (n=73) with insertion of Foley catheter (18 G and filled with 70 ml of distilled water) without tension. Primary outcome measures were spontaneous onset of labour within 24 hours and the mode of delivery. Maternal and fetal adverse effects were measured as secondary outcomes. Maternal age, period of gestation, pre induction cervical ripening Bishop's score and maternal BMI were compared as baseline characters of two groups. As measures of efficacy, spontaneous onset of labour, vaginal delivery rate and caesarean section rate were compared. Maternal and fetal adverse effects were used to compare the safety of the two methods. Results: Mean maternal ages were 27 and 28 years in group A and B respectively. Mean period of gestation was 40 weeks +5 days in both groups. Mean pre ripening Bishop's scores in group A was 4.24 ± 0.41and 4.63 ± 0.38 for group B. BMI of group A was 26.9 ± 1.43Kg/m 2 and 27.2 ± Kg/m 2 in group B. However, a significant difference was not observed between these two groups. While mothers in group A had 30.5% spontaneous onset of labour, only 24.6% mothers went into spontaneous onset of labour (p=0.78) in group B. Vaginal delivery rates were 77% and 72% in group A and B respectively (p=0.78). Respective Caesarean section rates of group A and group B were 22.8% and 27% (p=0.64). Mothers who had PGE 2 had significantly higher chances of experiencing side effects (44%) in compared to mothers who had Foley catheters (22%) (p=0.016). Mothers who had PGE 2 had significantly higher rates of uterine hyper-stimulation (p=0.01), nausea and vomiting (p=0.03) and fever more than 38 C° (p=0.03) while post-partum haemorrhage was not significant (p=0.071). Similar rates of meconium at ARM, fetal distress, APGAR<7 at 5 min and SBU admissions were experienced by fetuses and neonates in both groups (p=0.63). Conclusion: Insertion of Foley catheter to extra amniotic space is as effective as intra-cervical application of PGE 2 gel for pre induction cervical ripening. Due to lower maternal adverse effects, extra amniotic insertion of Foley catheter is safer than intra-cervical application of PGE 2 gel.

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Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping

Doany

McCarty

1997

J. Matern. Fetal Med.

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The purpose of the study was to determine the safety and efficacy of outpatient intravaginal prostaglandin E2 (PGE2) and membrane stripping in promoting labor in the uncomplicated postdate pregnancy. In a double‐blind placebo‐controlled study, 150 enrollees were randomized to one of four treatment groups: group 1, no membrane stripping and placebo gel; group II, no membrane stripping and PGE2 gel; group III, membrane stripping and placebo gel; and group IV, membrane stripping and PGE2 gel. The treatments were administered at 287 days (41 weeks) and 294 days (42 weeks) of gestation, then every 3–4 days until 307 days (43 completed weeks) of gestation. The patients in group IV had the shortest interval to delivery with a median of 1 day, P = .001, and had the fewest antenatal surveillance visits with only 21% requiring more than one visit, P = .02. Group I patients in comparison, had a 7‐day median to delivery, and 61% required more than one visit. The time spent in labor and delivery and the need for oxytocin augmentation was not significantly reduced in groups II, III, and IV. No adverse side effects to either mother or neonate could be directly attributed to this outpatient treatment combination. We conclude that intravaginal PGE2 gel combined with membrane stripping reduces postterm pregnancies and antenatal visits in our patients. J. Matern.‐Fetal Med. 6:71–78, 1997. © 1997 Wiley‐Liss, Inc.

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Induction of labor with intravaginal prostaglandin E₂gel

Abstract: The vaginal administration of 2.0 mg of PGE2 gel seems to be equally effective as 3.0 mg in terms of labor success rate with a significant lower incidence of side effects.

Cited by 14 publications

References 10 publications

Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping

Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping

Efficacy and safety of extra amniotic insertion of Foley catheter verses intra cervical application of PGE2 gel in pre-induction cervical ripening among primi mothers at 40 weeks +5 days or beyond – a randomized controlled study

Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping

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Induction of labor with intravaginal prostaglandin E2gel

Abstract: The vaginal administration of 2.0 mg of PGE2 gel seems to be equally effective as 3.0 mg in terms of labor success rate with a significant lower incidence of side effects.

Cited by 14 publications

References 10 publications

Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping

Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping

Efficacy and safety of extra amniotic insertion of Foley catheter verses intra cervical application of PGE2 gel in pre-induction cervical ripening among primi mothers at 40 weeks +5 days or beyond – a randomized controlled study

Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping

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Induction of labor with intravaginal prostaglandin E₂gel