DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20200892

A study to evaluate the efficacy of combined prostaglandins and vaginal estradiol compared to prostaglandin alone in labor induction

Anjana B., Saniya Sheikh

Abstract


Background: Induction of labor (IOL) is a process where labor is initiated artificially before its spontaneous onset for the delivery of feto placental unit by mechanical or pharmacologic methods.

Methods: The present Hospital based prospective randomized comparative study was conducted in the department of obstetrics and gynecology, KLES Dr. Prabhakar Kore Charitable Hospital, Belagavi during the period of January 2015 to December 2015.The selected women were randomized into two groups by simple randomization using an opaque sealed envelope, into either without vaginal estradiol Group A: Group PGE2 - Prostaglandin E2 gel intracervical alone group or Group B: PGE2 + E (Estradiol) - combined Prostaglandin E2 gel intracervical and 50 µg of estradiol tablet intravaginal group.

Results: In the present study 65% of the women in group PGE2 required three doses of prostaglandins compared to 23.33% in group PGE2 and estradiol for the cervix to become favorable. In this study there is significantly longer mean interval time noted for induction to cervical ripening (12.88±4.91 versus 8.92±5.07; p <0.001), induction to active labor (16.97±4.93 versus 11.02±4.72; p <0.001) and induction to delivery time (21.97±3.83 versus 13.14±4.98; p <0.001) in group PGE2 compared to combined PGE2 and estradiol group.

Conclusions: Thus, vaginal estradiol along with prostaglandins has the potential in cervical ripening and induce labor and in an efficacious way. There is beneficial fetal outcome when combined vaginal estradiol along with intracervical prostaglandin E2 was used.


Keywords


Estradiol, Fetal, Induction, Labour, Prostaglandin

Full Text:

PDF

References


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

Deshmukh VL, Yelikar KA, Waso V. Comparative Study of efficacy and safety of oral versus vaginal misoprostol for induction or labour. J Obstet Gynaecol India. 2013;63(5):321-4.

Abdel Hak AM, Hanafy A. Pre-induction cervical ripening with Prostaglandin E2 in Preterm Pregn. Med J Cairo Univ. 2010;78(1):307-11.

Mylonas I, Friese K. Indications for and risks of elective caesarean section. Dtsch Arztebl Int. 2015;112(29-30):489-95.

Mozurkewich EL, Chilimigras JL, Berman DR, Perni UC, Romero VC, King VJ, et al. Methods of induction of labor: a systematic review. BMC Preg Childbirth. 2011;11:84.

Shah K, Doshi H. Premature rupture of membrane at term: early induction versus expectant. Management 2012;62(2):172.

Bernstein P. Prostaglandin E2 gel for cervical ripening and labour induction: A multi-center placebo-controlled trial. CMAJ. 1991;145(10):1249-54.

Ulmsten U, Wingerup L, Ekman G. Local application of prostaglandin E2 for cervical ripening or induction of term labor. Clin Obstet Gynecol. 1983;26(1):95-105.

Dasgupta E, Singh G. Vaginal misoprostol vs vaginal misoprostol with estradiol for labor induction: a prospective double-blind study. 2012; 62(1): 47–51.

Leduc D, Bringer A, Lee L. Induction of labour. SOGC Clin Pract Guideline Induct Labor. 2013;296:840-58.