Vergleich zwischen Prostaglandin E₂-Gel und Oxytozin bei medizinisch indizierten Geburtseinleitungen

Abstract

The use of prostaglandins (PG) increasingly replaces the "classical" method of induction of labour by means of oxytocin and amniotomy, the last-named method being associated, especially in women with an unripe cervix, with side effects like prolonged labour and a higher rate of obstetric surgery. In this study the point of interest was whether prostaglandins offer any advantages over the classical method in respect of efficacy and maternal and foetal tolerance. 99 patients subdivided into primiparae and multiparae were randomly assigned to group A or B. In group A labour was induced with 1 mg resp. 2 mg PGE2 intravaginally at an interval of 6 hours. In group B the method of induction consisted of intravenous oxytocin and amniotomy. The success rate of induction was almost equal in both groups. However, in those patients where PGE2 induction did not succeed and who could not be delivered within 12 hours the cervical score was significantly improved in comparison to the oxytocin group. Based on the experience reported in the literature, one might speculate that an increased dosage could still improve the results of vaginally administered PGE2 gel.

Intravenous oxytocin alone for cervical ripening and induction of labour

“…Twenty-five trials compared oxytocin with a policy of expectant management (Akyol 1999; Alcalay 1996; Chang 1997; Damania 1992; Duff 1984; Grant 1992; Hannah 1996; Hjertberg 1996; Jagani 1984; Ladfors 1996; McCaul 1997; McQueen 1992; Morales 1986; Natale 1994; Ottervanger 1996; Puertas 1996; Ray 1992; Roberts 1986; Rydhstrom 1991; Sperling 1993; Tamsen 1990; Valentine 1977; Van Der Walt 1989; Wagner 1989; Wiqvist 1986). Twenty-seven trials compared oxytocin with vaginal PGE2 (Andersen 1990; Atad 1996; Chua 1991; Egarter 1987; Ekman 1986; Ekman-Ordeberg 1985; Griffith-Jones 1990; Hannah 1996; Herabutya 1991; Jagani 1984; Lange 1984; Legarth 1987; Lyndrup 1989; Lyndrup 1990; Macer 1984; Magos 1983; McCaul 1997; McQueen 1990; Olmo 2001; Pollnow 1996; Ray 1992; Roberts 1986; Rymer 1992; Silva-Cruz 1988; Valadan 2005; Van Der Walt 1989; Wilson 1978). Fourteen trials compared oxytocin with intracervical PGE2 (Ashrafunnessa 1997; Bilgin 1996; Bung 1986; Dominguez 1999; Goeschen 1989; Jackson 1994; Magann 1995; Malik 1996; Papageorgiou 1992; Parikh 2001; Puertas 1996; Ulmsten 1979; Wiqvist 1986; Zahradnik 1987).…”

“…Twenty-seven trials compared oxytocin with vaginal PGE2 (Andersen 1990; Atad 1996; Chua 1991; Egarter 1987; Ekman 1986; Ekman-Ordeberg 1985; Griffith-Jones 1990; Hannah 1996; Herabutya 1991; Jagani 1984; Lange 1984; Legarth 1987; Lyndrup 1989; Lyndrup 1990; Macer 1984; Magos 1983; McCaul 1997; McQueen 1990; Olmo 2001; Pollnow 1996; Ray 1992; Roberts 1986; Rymer 1992; Silva-Cruz 1988; Valadan 2005; Van Der Walt 1989; Wilson 1978).…”