Cervical Ripening with Intravaginal Prostaglandins E2 Gel

Ripening of the cervix by intravaginal application of a prostaglandin containing gel was evaluated. Thirty patients with an unfavorable cervix needing labor induction were studied in a double-blind prospective fashion. The prostaglandin gel proved superior to placebo in ripening the cervix (p 0.5), reducing induction failure (p 0.25) diminishing the oxytocin dosage necessary for induction {p 0.5) and lowering the rate of cesarean section (p 0.1). One hundred fifty additional patients with varying Bishop scores and differing clinical situation were also studied. There were 35 cesarean sections (23.3%), nine failed inductions (6%), a spontaneous labor rate of 46% and an average Bishop score change of 2.5. Twenty patients with premature rupture of the membranes and an unfavorable cervix received a modified gel containing 2.5mg of prostaglandin E2. Average Bishop score change was 2.9, and there was 55% incidence of spontaneous labor.