Abstract
Aim: to evaluate the efficacy of instillation of intravaginal prostaglandin E2 gel in cervical ripening.
 Materials and methods: The present prospective comparative interventional study was conducted in the Department of Obstetrics and Gynecology, Nalanda Medical College and Hospital, Patna, Bihar. Total 60 patients were divided in to two groups. Group I (n=30): received two doses of 2 mg prostaglandin gel intravaginally, 6 hours apart, Group II (n=30): received single dose of 2 mg prostaglandin gel intravaginally. After administering the gel into the posterior fornix under aseptic conditions the woman was kept on the bed for 30 minutes and was observed for contractions, rupture of membranes, bleeding or fetal heart rate changes. The patients were also assessed to determine the modified Bishop score.
 Results: Both the groups were comparable in demographic factors like age and period of gestation. The most common indication for induction was past dates followed by gestational hypertension and Oligohydramnios.
 Conclusion: The study showed that intravaginal application of prostaglandin E2 is an effective, safe and acceptable method for induction of labor in women with unfavorable cervix and indications for induction.
 Keywords: prostaglandin E2, labor, gestational hypertension, vaginal delivery, Bishop score
Highlights
Induction of labour has become an integral part of modern Obstetrics
Local use of prostaglandin E2 (PGE2) by extra-amniotic, intravaginal and intracervical route has been found to be effective in priming the cervix and inducing labour in patients at tenn with poor Bishop score.[5,6,7]
A single application of PGE2 gel has been reported to be successful in 83% to 96% of cases
Summary
Induction of labour has become an integral part of modern Obstetrics. It is indicated when the benefits to either the mother or fetus outweigh those of continuing the pregnancy.[1]Local use of prostaglandin E2 (PGE2) by extra-amniotic, intravaginal and intracervical route has been found to be effective in priming the cervix and inducing labour in patients at tenn with poor Bishop score.[5,6,7] Extra-amniotic use, besides being invasive is associated with increased risk of introducing infection.Induction of labor should be simple, safe, effective and preferably non-invasive. Induction of labour has become an integral part of modern Obstetrics. It is indicated when the benefits to either the mother or fetus outweigh those of continuing the pregnancy.[1]. Local use of prostaglandin E2 (PGE2) by extra-amniotic, intravaginal and intracervical route has been found to be effective in priming the cervix and inducing labour in patients at tenn with poor Bishop score.[5,6,7] Extra-amniotic use, besides being invasive is associated with increased risk of introducing infection. Induction of labor should be simple, safe, effective and preferably non-invasive. The success of induction depends to a large extent on the consistency, compliance and configuration of the cervix.[2] The unripe cervix remains a well recognized impendent to the successful induction of labour.[3]
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