Avoiding cesarean deliveries by intravenous prostaglandin E2 administration (PGE2)

Abstract

The study reported here was prompted by the question whether caesarean deliveries which would otherwise be necessary can be avoided by intravenous infusion of prostaglandin E2 (PGE2). The authors consider intravenous administration of PGE2 during delivery to be indicated in cases which fail to respond to therapy after three local cervical maturation attempts and in standstills where oxytocin has no effect. Out of a total of 5835 women who gave birth at the Obstetrics Department of the Berlin-Neukölln Gynecological Clinic between 1980 and 1981, those who had been given intravenous infusions of PGE2 were identified and a check was made to establish whether this treatment offers any advantages. PGE2 infusion after unsuccessful intracervical application of PGE2 gel: Out of 1122 risk patients in whom cervical maturation prior to induction of birth appeared desirable, 43 (3.8%) still had a Bishop Score of less than or equal to 7 after three local applications of PGE2 gel. Attempts to achieve a vaginal delivery in spite of this, by means of PGE2 infusion, were successful in 60% of the cases. The mean rate of PGE2 infusion was 1.1 +/- 0.3 microgram/min. Four women were given oxytocin in addition, in an average dose of 9.3 +/- 1.1 mU/min. The average duration of labour was 10 hours 30 min. Complications in mother and child occurred no more frequently than in other risk births. PGE2 infusion in cases with standstill not responding to oxytocin treatment: In 82 parturients (1.4%) a standstill occurred during labour after initially normal dilation of the cervix, and could not be overcome by administration of oxytocin.(ABSTRACT TRUNCATED AT 250 WORDS)