Randomized Trial of Vaginal Prostaglandin E₂ Versus Oxytocin for Labor Induction in Term Premature Rupture of Membranes

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• 作者：Cigdem Kunt ; Mine Kanat-Pektas ; Ayse Nur Cakir Gungor ; Raziye Keskin Kurt ; Mustafa Ozat ; Cavidan Gulerman ; Tayfun Gungor ; Leyla Mollamahmutoglu
• 关键词：Bishop score ; labor induction ; oxytocin ; premature rupture of membranes ; prostaglandin E₂
• 刊名：Taiwanese Journal of Obstetrics and Gynecology
• 出版年：2010
• 出版时间：March 2010
• 年：2010
• 卷：49
• 期：1
• 页码：57-61
• 全文大小：149 K

文摘

Summary

Objective

The aim of this study was to compare the efficacy and safety of a prostaglandin E₂ (PGE₂) vaginal insert with those of oxytocin for labor induction. The present study also examined whether its use reduces the rate of cesarean delivery in term pregnancies with premature rupture of membranes (PROM) and low Bishop scores.

Materials and Methods

A total of 240 women with singleton pregnancies at ≥ 37 weeks, no prior uterine scar, vertex presentations, reactive nonstress tests, PROM for ≥ 12 hours and Bishop scores of ≤ 6 were randomly assigned to receive either oxytocin or vaginal PGE₂. The primary outcomes were time from induction to delivery and mode of delivery.

Results

The time from labor induction to active labor onset was significantly shorter in the oxytocin group than in the PGE₂ group (4.9 ± 4.1 vs. 8.5 ± 3.6 hours; p = 0.02). The time from induction to delivery was also significantly shorter in the oxytocin group (3.4 ± 1.5 vs. 9.6 ± 4.7 hours; p = 0.02). Cesarean delivery rates were statistically similar in the oxytocin and PGE₂ groups (18.3 vs. 20.0 % ; p = 0.81). Neonatal outcomes were comparable in both groups. Comparable results were observed for nulliparous women included in the study population.

Conclusion

Oxytocin treatment seems to be superior to vaginal administration of PGE₂ to induce labor in term pregnancies complicated with PROM and unfavorable services.