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Cervical ripening and induction of labor by intracervical and extra‐amniotic prostaglandin gel application in cases of intrauterine fetal death
Author(s) -
Rath Werner,
Kuhn Walther
Publication year - 1985
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/0020-7292(85)90147-x
Subject(s) - medicine , labor induction , ripening , obstetrics , induction of labor , amniotic fluid , prostaglandin , fetus , andrology , gynecology , pregnancy , oxytocin , food science , chemistry , biology , genetics
In 42 patients with intrauterine fetal death between the 29th and 43rd week of gestation, a standard, 2‐step procedure was employed to deliver the dead fetus. After priming with an intracervical application of PGF 2 α‐ or PGE 2 ‐gel, labor was induced by extra‐amniotic prostaglandin (PG) gel or oxytocin infusion while under epidural anesthesia. Intracervical PG application led to a significant improvement in the modified Bishop score from 1.3 to 7.6 after a mean of 8 h. In 20 patients labor and progressive dilatation of the cervix occurred after intracervical PG gel application alone. The average total therapy time was 18.1 h in patients treated with PGF 2 α and 13.7 h in the PGE 2 ‐treated group. The average induction of labor to delivery intervals were 8.8 h in the PGF 2 α‐ and 7.1 h in the PGE 2 ‐group. Gastrointestinal side effects were observed in only 5 patients. The combination of cervical ripening with intracervical PG gel application and induction of labor by extra‐amniotic PG gel under epidural anesthesia is an efficient and safe method for treatment of intrauterine fetal death.