Open AccessPreinductive Cervical Ripening With PgE 2 Gel in Term Pregnant Women with Ultrasonically Diagnosed Intra‐Uterine Growth‐Retarded Fetuses
Author(s) -
Almström H.,
Ekman G.,
Granström L.
Publication year - 1991
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 - 10.3109/00016349109007916
Subject(s) - medicine , cervix , obstetrics , fetal distress , ripening , labor induction , prospective cohort study , pregnancy , fetus , bishop score , gynecology , caesarean section , oxytocin , surgery , cancer , endocrinology , chemistry , food science , biology , genetics
Intra‐uterine growth retardation (IUGR), often combined with other pregnancy‐related complications, constitutes a rather common indication for labor induction. The objective of this prospective study was to evaluate a strict intracervical application of 0.5 mg PgE 2 in gel for cervical ripening and labor induction. Eighty term pregnant women with an ultrasonically diagnosed IUGR (<‐2 SD) and an unripe cervix were given PgE 2 ‐gel. The main indication for labor induction was IUGR, but 26 women had other complications. IUGR was verified at delivery in 50 women (study group), whereas 30 women (control group) gave birth to infants of normal birth weight (>‐2 SD). The cervical ripening effect did not differ between the groups. In the study group, 19 nulliparous and 15 parous women out of 50 had a favorable cervix after 12 h and were delivered within 24 h of gel application. The corresponding result for the control group was 11 nulliparous and 8 parous women out of 30. Failed induction was registered in 2 and one woman respectively. On the other hand, the number of instrumental deliveries was greater in the study group, 11 caesarean sections (CS) and seven ventouses, compared with one CS and three ventouses in the control group (p < 0.05). The frequency of operative deliveries for fetal distress (ODFD) was higher among the women with verified IUGR (14/50) than in the controls, where the corresponding figure was 3/30. No side effects were observed. We conclude that strict intracervical application of 0.5 mg PgE 2 is a safe and effective method for cervical ripening and labor induction in women with IUGR.