Pre-induction cervical ripening with extra-amniotic and vaginal prostaglandin E₂

Summary

Fifty primigravidae with a cervical score of <4 were allocated at random to receive either 500 μg prostaglandin E₂ extra-amniotically via a Foley catheter or two 3 mg prostaglandin E₂ vaginal tablets inserted 4 hours apart, the evening before planned induction of labour with amniotomy and intravenous oxytocin. The mean changes in cervical score overnight did not differ between the two groups and the number of women requiring oxytocin was similar. There was no difference in the priming-delivery interval or amniotomy-delivery interval. The mean priming-amniotomy interval was shorter in the extra-amniotic group (p<002) and more patients required opiate analgesia following priming but before induction or diagnosis of labour in this group (p< 0.01). There was no difference between the groups in terms of mode of delivery or neonatal outcome.