COMPARISON OF PROSTAGLANDIN E2 GEL, PROSTAGLANDIN E2 PESSARY AND EXTRA-AMNIOTIC SALINE INFUSION WITH OXYTOCIN FOR INDUCTION OF LABOUR
AbstractBackground: Induction of labour is the intentional initiation of cervical ripening and uterinecontraction for the purpose of accomplishing delivery, prior to onset of spontaneous parturition. Thisstudy was conducted to compare maternal and neonatal outcome in women induced with ProstaglandinE2 gel, Prostaglandin E2 pessary and extra-amniotic saline infusion with oxytocin at Bishops score <5.Methods: It was a quasi-experimental which was conducted at the Department of Gynaecology andObstetrics Unit-I, Mother and Child Health Care Centre, Pakistan Institute of Medical Sciences,Islamabad during one year of time. Eighty cases in each group (prostaglandin gel, prostaglandinE2pessary and extra-amniotic saline infusion with oxytocin) were collected. Systematic sampling wasdone. First woman admitted was induced with prostaglandin gel, the second one with prostaglandinpessary and the third was induced with extra amniotic saline infusion and oxytocin. Results: The mostcommon indication for induction was post dates followed by PIH. The induction labour interval wasless in EASI with oxytocin group (5.18±3.4) hours, as compared to prostaglandin pessary (8.81±5.60)hours and prostaglandin gel (8.32±5.18) hours. Induction delivery interval in EASI with oxytocin was(10±5.6) hours as compared to prostaglandin pessary (14±6.3) hours and prostaglandin gel (13±7.1)hours. This difference was statistically significant. The primigravidas had longer duration of labour thanmultigravidas. Induction labour interval in primigravidas was (8.2±5.1) hours while in multigravidas itwas (6.7±5.02) hours. Induction delivery interval was also more in primigravidas (13.6±6.80) hours ascompared to multigravidas (11.4±6.20) hours. Vaginal delivery rate was 89.2% while the caesareansection rate was 10.4%. The most common indication for caesarean section was foetal distress. Therewas no significant difference in perinatal morbidity and mortality in the three groups. Conclusion:EASI with oxytocin is a better method of induction than prostaglandin E2 gel and pessary. Moreover itis more economical in our country.Keywords: Induction of labour, Bishop score, EASI, Prostaglandin E2
Creasy RK. Induction of labour. In: Creasy RK, editor.
Management of labour and delivery. Malden: Blackwell Sciences
American College of Obstetricians and Gynaecologists.
Induction and augmentation of labour. ACOG technical bulletin
No. 217. Washington DC: ACOG; 1995.
Rana S. Termination of pregnancy. In: Rana S, editor. Obstetrics
and perinatal care. Islamabad: SAF publishers 1998:937–53.
Harman JH, Kim A. Current trends in cervical ripening and
labour induction. Am Fam Physician 1999;60:477–84.
Mazhar SB, Sarwar S, Mahmud G. Induction of labour, a
randomized trial comparing prostaglandin E2 pessary,
intracervical Foley catheter and extra amniotic saline infusion. J
Buccellato CA, Stika CS, Frederiksen MC. A randomized trial of
misoprostol versus extra-amniotic sodium chloride infusion with
oxytocin for induction of labor. Am J Obstet Gynecol
Duff C, Sinclair M. Exploring the risks associated with induction
of labour. J Adv Nurs 2000;31:410–7.
Buist R. Induction of labour: indications and obstetric outcome in
a tertiary referral hospital. NZ Med J 1999;112:251–3.
Dublin S, Lydon RM, Kaplan RC, Critchlow CW, Watts DH.
Maternal and neonatal outcome after induction of labour without
an identified indication. Am J Obstet Gynaecol 2000;183:986–94.
Shetty A, Livingston I, Acharya S, Templeton A. Vaginal
prostaglandin E2 gel versus tablet in the induction of labour at
term-a retrospective analysis. Shetty A, Livingston I, Acharya S,
Templeton A. J Obstet Gynaecol. 2004;24(3):243–6.
Kho EM, Sadler L, McCowan L. Induction of labour: a
comparison between controlled-release dinoprostone vaginal
pessary (Cervidil) and dinoprostone intravaginal gel (Prostin E2).
Aust NZ J Obstet Gynaecol 2008;48:473–7.
Sharami SH, Milani F, Zahiri Z, Mansour-Ghanaei F. A
randomized trial of prostaglandin E2 gel and extra-amniotic
saline infusion with high dose oxytocin for cervical ripening.
Med Sci Monit 2005;11:CR381–6.
Guinn DA, Davies JK, Jones RO, Sullivan L, Wolf D. Labor
induction in women with an unfavorable Bishop score:
randomized controlled trial of intrauterine Foley catheter with
concurrent oxytocin infusion versus Foley catheter with extraamniotic saline infusion with concurrent oxytocin infusion. Am J
Obstet Gynecol 2004;191(1):225–9.
Mazhar SB, Imran R, Alam K.. Trial of extra amniotic saline
infusion with oxytocin versus prostaglandin E2 pessary for
induction of labour. J Coll Physicians Surg Pak. 2003;13:317–20.
Al-Taani MI. Intravaginal prostaglandin-E2 for cervical priming
and induction of labour. East Mediterr Health J 2007;13:855–61.
Rayburn WF, Lightfoot SA, Newland JR,
Smith CV, Christensen HD. A model for investigating
microscopic changes induced by prostaglandinE2 in the term
cervix. J Maternal Foetal Invest. 1994;4:137–40.
Keirse MJNC: Prostaglandins in preinduction cervical ripening.
Meta-analysis of worldwide clinical experience. J Reprod Med
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