Intravaginal prostaglandin-E2 for cervical priming and induction of labour.

A prospective study examined the safety, efficacy and labour outcome in 436 women undergoing labour induction using intravaginal prostaglandin E2. Women with singleton pregnancies (235 nulliparas and 201 multiparas) were recruited if they had a clinically unfavourable cervix, and indications for induction. The mean (standard deviation) interval from initiation to delivery was statistically significantly shorter in multiparas than nulliparas: 13.5 hours (SD 1.8) versus 15.5 hours (SD 2.4). No more than 2 x 3 mg tablets were needed to achieve a clinically feasible cervix for amniotomy. The overall need for oxytocin augmentation of labour was 42%, significantly higher in nulliparas (47%) than multiparas (35%). Intrapartum complications, caesarean section and perinatal deaths showed no statistically significant differences between the groups.