Comparison of efficacy and safety of intravaginal dinoprostone (PGE2) gel and intracervical dinoprostone (PGE2) gel for cervical ripening and induction of labour at term
Journal Title: Medpulse International Journal of Gynaecology - Year 2019, Vol 10, Issue 2
Abstract
Background:Induction of labor is the stimulation of uterine contractions before the spontaneous onset of labor, with or without rupture membranes.Invention of prostaglandin preparation have revolutionized the methods of induction especially in unripe cervix and today, prostaglandins in various forms are used mainly for induction of labour with low Bishop’s score. Different preparations and different routes of administration of dinoprostone are used, for e.g. gels, tablets, pessaries, sustained release inserts.Material and methods:This prospective randomized control trial was carried out in the Department of Obstetrics and Gynecology at Princess Esra Hospital from 1/02/2017 till 30/07/2018 after obtaining permission from Institutional Ethics Committee. Accordingly 200 women who fulfilled inclusion/exclusion criteria and for induction of labour were enrolled in the study.These women were randomized into two groups, Group A and Group B.Observation and Results: With intracervical dinoprostone, early onset of labour pain was observed as compared to intravaginal dinoprostone gel. But at the end of 24 hours 99% in group A, 100% patients in group B started uterine contractions. With intracervical dinoprostone gel, active phase of labour was attained earlier as compared intravaginal route but, it was seen that at the end of 24 hours 88% in group A and 93% patient in group B went into active phase. The induction delivery interval was less with intracervical dinoprostone as compared to intravaginal dinoprostone.63% women in group A and 61 % in group B delivered vaginally indicating effectivity of dinoprostone in vaginal delivery by both the groups.Conclusion:Intravaginal dinoprostone in the dose of 0.5 mg 8 hourly for induction of labour in unripe cervix should be considered as safe and effective method which is free of complication and has high success rate with minimal maternal and fetal morbidity.
Authors and Affiliations
Anjum Kekhashan, Ismath Fatima
Keywords
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