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Cervical Ripening With Intravaginal Prostaglandin E₂Gel

From The Women's Clinic, Emanuel Hospital, Oregon Health Sciences University, Portland, Oregon

Abstract

Ripening of the cervix by intravaginal application of a prostaglandin-containing gel is evaluated. Thirty patients with an unfavorable cervix needing labor induction were studied in a double-blind, prospective fashion. The prostaglandin gel proved superior to placebo in ripening the cervix (P<.05), reducing induction failures (P<.025), diminishing the oxytocin dosage necessary for induction (P<.05), and lowering the rate of cesarean section (.05<P<.1). One hundred fifty additional patients with varying Bishop scores and differing clinical situations were also studied. There were 35 cesarean sections (23.3%), nine failed inductions (6%), a spontaneous labor rate of 46%, and an average Bishop score change of 2.5. Twenty patients with premature rupture of the membranes and an unfavorable cervix received a modified gel containing 2.5 mg of prostaglandin E₂. Average Bishop score change was 2.9, and there was a 55% incidence of spontaneous labor.