Intracervical PGE2 gel application for cervical ripening and induction of labour: a clinical study

Authors

  • Shilpa Modi Department of Obstetrics and Gynecology, KBNIMS, Gulbarga, Karnataka, India
  • Jayalaxmi Mahur Department of Obstetrics and Gynecology, KBNIMS, Gulbarga, Karnataka, India
  • Shashank V. S. Department of Obstetrics and Gynecology, KBNIMS, Gulbarga, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20193771

Keywords:

Bishop score, Cervical ripening, Intracervical PGE2, Induction of Labour, Inductional delivery interval, Oxytocin augmentation

Abstract

Background: PGE2 gel (cerviprime) not only helps in cervical ripening but also sensitizes the uterine musculature to physiological PGE2 for generation and maintenance of uterine contractions. In the present study the efficacy of PGE2 intracerival gel for ripening and induction of labour has been reported.

Methods: This is a randomized prospective study of 80 cases admitted to the labour room during period of 2 years i.e. March 2017 to March 2019 in Department of Obstetrics and Gynecology, KBNIMS, Gulbarga, Karnataka. All patients had clear indications for termination of pregnancy. The initial bishop score determined prior to induction by pelvic examination. Under aseptic precautions PGE2 endocervical gel was instilled. The results analyzed for successful ripening, induction delivery interval, results in primigravida and multigravida with single instillation or reinstallation if required, mode of delivery and maternal and perinatal complications.

Results: The present study of 80 cases showed that a single application of intracervical PGE2 gel caused favorable changes in cervix by increasing Bishop score and shortened induction delivery interval with minimal side effects. Successful ripening with single application was achieved in 92.5% of cases (primi 42.5% and multi 50%). Only 6.25% of primi's and 1.25% of multi’s required reinstallation of PGE2 gel. Successful induction was achieved in 47.5% primi's and 50% multi’s i.e. 97.5% cases.

Conclusions: The study concludes that single low dose intracervical PGE2 (cerviprime) gel proved to a safe, reliable and effective method for cervical ripening and induction of labour.

References

Krishnandu G. Induction of Labour. Principles Protocols Practices FOGSI – ICOG; 2018:40-47.

Arias F. Pharmacology of Oxytocin and prostaglandins. Clin Obstet Gynecol. 2000;43:455-68.

Witter FR. Prostaglandin E2 preparations for preinduction cervical ripening. Clin Obstet Gynecol. 2000;43:469-74.

Goetzl L. Methods of cervical ripening and labour induction: Pharmacologic. Clin Obstet Gynecol. 2014;57:377-90.

Calder AA, Embrey MP. Prostaglandins and the unfavorable cervix. Lancet. 1973;2(7841):1322-3.

Cunningham FG, Lenovo KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Induction and augmentation of labour. Williams Obstetrics, New York (NY): McGraw-Hill; 2014;25:506-7.

Kore S, Karnik H, Arora P, Khedekar GN, Vidya PR. Use of endocervical PGE2 (Dinoprostone) gel for induction of labour. J Obset Gynaec India. 1996;4:482-6.

Mukharjee K, Neogi V, Gangooli U, Mishra R. A comparative study of induction of labour by PGE2 and oxytocin and its outcome. J Obstet Gynaec India. 1996;46(5):631.

Brindley BA, Sokol RJ. Induction and augmentation of labour: basis and methods for current practice. Obset Gynecol Survey. 1988;43:730-43.

Embrey MP, Calder AA, Hillier K. Extraamniotic prostaglandin E2 for induction of labour at term. J Obset Gynaecol Br Commonwealth. 1974;81:39-44.

Thiery M, Dewster JM, Parewijick W, Noah ML. Endocervical prostaglandin E2 gel for preinduction cervical softening. Clin Obstet Gynecol. 1984;27:429-39.

Noah ML, Decoster JM, Fraser W. Preinduction cervical softening with endocervical PGE2 gel. A multicenter trial. Acta Obstet Gynecol Scand. 1987;66:3-7.

Trofalter KF. Endocervical prostaglandin E2 gel for preinduction cervical ripening. Clinical trial results. J Reprod Med. 1993;38(1suppl):78-82.

Pollnow DM, Broekhuizen FF. Randomized double blind trial of PGE2 intravaginal gel versus low dose oxytocin for cervical ripening before induction of labour. Am J Obstet Gynecol. 1996;174:1910-3.

Niloufur Syed B. A study of intracervical PGE2 gel for cervical ripening and induction of labour. Int J Contemp Med Res. 2018;5(3):C4-C7.

Behra RC, Kandoth SK, Goyal BK. Labour induction in unfavourable cervix (a prospective study). J Obstet Gynecol India. 1997;47(1):53-61.

Downloads

Published

2019-08-26

Issue

Section

Original Research Articles