A study on comparison of cerviprime and IV oxytocin in labour induction and evaluation of changes in the bishop’s score with these two agents


  • Durvasula Lakshmi Swapna Department of Obstetrics and Gynecology, Gayatri Vidya Parishad IHC and MT, Visakhapatnam, Andhra Pradesh, India
  • Swetha Sree Department of Obstetrics and Gynecology, Gayatri Vidya Parishad IHC and MT, Visakhapatnam, Andhra Pradesh, India




Bishop’s score, Cesarean rate, Failed induction, Induction of labour, Vaginal delivery rate, PGE2 gel, Maternal outcome, Neonatal outcome, Oxytocin


Background: There are several strategies for the induction of labor (IOL), and pharmacologic agents, including oxytocin and prostaglandins, are most commonly used in clinical practice. Compared with oxytocin, the prostaglandin E2 agent, dinoprostone, has been regarded as moreeffective for the induction of labor of LTPs with a non-dilated cervix. Objective was to compare the PGE2 gel placed intracervically with that of oxytocin given intravenously for induction of labor in both primipara as well as multipara with the comparison of Bishop’s score at the starting of induction and its improvement with both of these inducing agents in those with indications for induction with gestational age greater than 36 weeks.

Methods: Hospital based prospective observational study over a period of one year on patients attending the antenatal and high-riskpregnancy clinic and scheduled for induction of labor with Bishop score <4.

Results: The number of successful induction was low in primiparae group with low Bishop’s score (1-2). There were greater number of successful inductions in both primi as well as multiparae with higher Bishop’s score.

Conclusions: When a primigravida had a low cervical score or an unfavourable cervix, intracervical PGE2 gel was found to be more effective at ripening the cervix and inducing labour. Both medicines were equally effective at inducing labour in cases of multigavidae with any Bishop's score and primi with a higher Bishop's score.


Saccone G, Berghella V. Induction of labor at full term in uncomplicated singleton gestations: A systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2015;213(5):629-36.

Sanchez-Ramos L. Dinoprostone vaginal insert for cervical ripening and labor induction: A meta-analysis. Obstet Gynecol. 2001;98(3):519-20.

Reinhard J, Rösler R, Yuan J, Schiermeier S, Herrmann E, Eichbaum MH, et al. Prostaglandin E2 labour induction with intravaginal (Minprostin) versus intracervical (Prepidil) administration at term: Randomized study of maternal and neonatal outcome and patient’s perception using the Osgood semantic differential scales. BioMed Res Int. 2014;2014:682919.

World Health Organisation. Recommendations for Induction of Labour. Geneva: 2011, 2011. Available at: https://www.who.int/publications/i/item/156. Accessed on 06 April 2011.

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 N Z J Obstet Gynaecol. 2008;48(5):473-77.

Barrilleaux PS, Bofill JA, Terrone DA, Magann EF, May WL, Morrison JC. Cervical ripening and induction of labor with misoprostol, dinoprostone gel, and a Foley catheter: A randomized trial of 3 techniques. Am J Obstet Gynecol. 2002;186(6):1124–29.

Alfirevic Z, Kelly AJ, Dowswell T. Intravenous oxytocin alone for cervical ripening and induction of labour. Coch Datab Syst Rev. 2009;(4):CD003246.

Koc O, Duran B, Ozdemirci S, Albayrak M, Koc U. Oxytocin versus sustained-release dinoprostone vaginal pessary for labor induction of unfavorable cervix with Bishop score ≥4 and ≤6: A randomized controlled trial. J Obstet Gynaecol Res. 2013;39(4):790-98.

Akay NÖ, Hızlı D, Yılmaz SS, Yalvaç S, Kandemir Ö. Comparison of low-dose oxytocin and dinoprostone for labor induction in postterm pregnancies: A randomized controlled prospective study. Gynecol Obstet Invest. 2012;73(3):242-47.

Ashraf M. A comparative study of prostagladin E2 gel (intracervical versus oxytocin drip in induction of labour. JK Pract. 2000;7(4):264-6.

Kim SH, Bennett PR, Terzidou V. Advances in the role of oxytocin receptors in human parturition. Mol Cell Endocrinol. 2017;449:56-63.

Kishore AH, Liang H, Kanchwala M, Xing C, Ganesh T, Akgul Y, et al. Prostaglandin dehydrogenase is a target for successful induction of cervical ripening. Proc Natl Acad Sci USA. 2017;114(31):E6427-36.

Galal M, Symonds I, Murray H, Petraglia F, Smith R. Postterm pregnancy. Facts Views Vis Obgyn. 2012;4(3):175–87.

Leppert PC. Anatomy and physiology of cervical ripening. Clin Obstet Gynecol. 1995;38(2):267-79.






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