Open AccessInduction of Labor by Intra‐Cervical Pge 2 in Viscous Gel: Mechanism of Action and Clinical Treatment Routines
Author(s) -
Wiqvist Ingrid,
Norström Anders,
Wiqvist Nils
Publication year - 1986
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016348609157391
Subject(s) - oxytocin , medicine , cervix , bishop score , placebo , pregnancy , group b , anesthesia , endocrinology , biology , alternative medicine , pathology , cancer , genetics
Induction of labor in women with immature cervix was accomplished by four different treatment schedules. the case material included a total of 100 subjects, each treatment group having 25 cases: Group A: Intravenous oxytocin; Group B: Intracervical PGE 2 ‐gel followed by intravenous oxytocin; Group C: Intracervical PGE 2 ‐gel twice with a 12‐hour interval; Group D: Intracervical placebo gel twice with 12‐hour interval. Oxytocin did not influence the Bishop score (B.S.) unless in the presence of active labor contractions. in contrast, there was an increment in B.S. by 3.6 points on average within 12 hours following PGE 2 ‐gel as calculated from data of subjects without signs of contractions. These results support the concept of a local action of PGE 2 ‐gel. the increment in B.S. was larger in subjects with very immature cervices (B.S. 2) than in those with moderately immature scores (B.S. 4). a second PGE 2 ‐gel instillation did not increase the B.S. above the level achieved by the first application, indicating that pharmacological ripening of the cervix by a single dose of PGE 2 results in an effect approaching maximum. The success rate was the same for oxytocin and PGE 2 ‐gel treated women during the first 24 hours, when approximately 40% of the women had given birth. the oxytocin group remained at that level of success rate, whereas the PGE 2 ‐gel‐oxytocin and PGE 2 ‐gel × 2 series continued to improve their success rate up to 75%. An interesting finding in the study was that women given PGE 2 ‐gel twice did not need intravenous oxytocin stimulation except in a few cases.