Objective. To compare labor induction with oral prostaglandin-E1 treatment to vaginal prostaglandin-E2 gel in primiparous women and women with an unripe ...
TITLE.
ADVANTAGE FOR LABOR INDUCTION WITH ORAL PROSTAGLANDIN-E1 TREATMENT COMPARED TO VAGINAL PROSTAGLANDIN-E2 GEL IN PRIMIPAROUS WOMEN AND WOMEN WITH AN UNRIPE CERVIX AUTHOR/S.
Thorbiornson A (SE) [1], Vladic T (SE) [2], Vladic Stjernholm Y (SE) [3]
ABSTRACT.
Objective. To compare labor induction with oral prostaglandin-E1 treatment to vaginal prostaglandin-E2 gel in primiparous women and women with an unripe cervix. Methods. The WHO International Classification of Diseases (ICD)-10 diagnoses and the obstetric records for all women who had labor induced with oral prostaglandin-E1 treatment (n=265) or vaginal prostaglandin-E2 gel (n=252) at the Department of Women´s and Children´s Health, Karolinska University Hospital, Solna, Sweden during 2012 and 2013 were examined. Results. In primiparous women, oral prostaglandin-E1 resulted in vaginal birth within 24 hours in 40.2% compared to 41.4% with vaginal prostaglandin-E2 (p < 0.001), whereas cesarean section was necessitated in 25.0% compared to 41.4% (p < 0.001). In women with Bishop score 0-2, oral prostaglandin-E1 resulted in vaginal birth within 24 hours in 42.7% compared to 46.1% with vaginal prostaglandin-E2 (p < 0.001), and cesarean section in 27.3% compared to 38.2% (p < 0.001). The induction to vaginal delivery interval was 3-5 hours longer with oral prostaglandin-E1. The rates of obstetric bleeding > 1000 mL, chorioamnionitis, uterine hyperstimulation and neonatal Apgar score < 7 at 5 min were comparable with the two methods (p > 0.05). Conclusions. Oral prostaglandin-E1 treatment was less efficacious than vaginal prostaglandin-E2 gel in achieving vaginal birth within 24 hours in primiparous women and women with an unripe cervix, and resulted in a 3-5 hours longer induction to vaginal delivery interval. However, oral prostaglandin-E1 was advantageous in terms of safety compared to vaginal prostaglandin-E2 gel in these subgroups, since this method resulted in fewer CS.
INSTITUTE.
[1] Karolinska Institute, [2] Karolinska Institute, [3] Karolinska Institute
