TITLE:
A Study on Pre-Induction Cervical Ripening with PGE2 Vaginal Tablet One (3 mg) vs. Half (1.5 mg) in Low Risk Multi Parous Mothers at 40 Weeks of Gestation
AUTHORS:
Naleen Ratnayake, Ahangama Arachchige Nilanga Nishad, Yahampath Arachchige Gamini Perera, Devasuriya Pathinayakalage Lanka Rasanjana, Samarakoon Mudiyanselage Sameera Gayanath Gunarathna, Prabath Kularathna Abeysundara
KEYWORDS:
Pregnancies, PGE2
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.8,
August
17,
2021
ABSTRACT: Backgrounds: Induction of labor is a common practice. In women with immature cervix, PGE2 is commonly used for
pre-induction. We hypothesized that PGE2 1.5 mg may be equally effective to PGE2 3 mg in multiparous women for labor induction. The
present effort was an attempt to compare the efficacy and effects of
pre-induction cervical ripening with PGE2 3 mg vs. 1.5 mg in multi-parous mothers (2nd and 3rd Pregnancy)
at 40 weeks. Methods: A double-blind randomized controlled trial was carried out at
Castle Street Hospital for Women, Colombo, Sri Lanka. Study subjects consisted
of women with singleton pregnancy (no cesarean history) admitted for delivery
at 40 weeks of their 2nd or 3rd pregnancy. PGE2 1.5 mg vs. 3 mg PGE2 vaginal tablet were used for treatment (n = 173) and control (n = 170)
groups, respectively. Cervical ripening and maternal, fetal complications were
observed. Unfavorable cervices were induced with the same PGE2 dose in the following day. Results: Study group,
compared with the control group, achieved the same rate of favorable cervices
in 1st and 2nd cycles (63.5% vs. 64%, respectively). Both groups showed the same
rate of cervical dilatation achievement, and admissions to Special Care Baby Unit.
Study group showed significantly less maternal complications (4% and 11%,
respectively: p = 0.01). Conclusion: PGE2 of 1.5 mg is equally effective in achieving favorable
cervices, adequate cervical dilatation with minimum maternal complications
compared to the usual 3 mg dose in multiparous low-risk women.