Extra-amniotic saline infusion versus extra-amniotic prostaglandin F 2α for cervical ripening and induction of labor

Abstract

Objective: To compare the effectiveness of extra-amniotic saline infusion versus extra-amniotic prostaglandin F 2α for cervical ripening, induction of labor and achievement of vaginal delivery in patients with unfavorable cervices. Method: A randomized trial of extra-amniotic saline infusion versus extra-amniotic prostaglandin F 2α performed at Harare Central Hospital Maternity Unit, Zimbabwe. One hundred and sixty-four patients were recruited from those referred to Harare Central Hospital Maternity Unit who required induction of labor for either maternal or fetal indications. Results: 162 patients (extra-amniotic PgF 2α group, N=81; extra-amniotic saline infusion group, N=81) had complete information. Two patients (one from each group) were lost to follow up. The demographic characteristics of the patients and the indications for induction were not statistically different. There was a marginally statistically significant difference in the change of Bishop Score in favor of the extra-amniotic saline infusion (4.0, S.D.=1.4) as compared to (4.5, S.D.=1.5) for extra-amniotic PgF 2α ( P value=0.047). All other parameters showed no statistically significant differences. Maternal and fetal complications were minimal and not significantly different. Extra-amniotic saline infusion was however almost six times cheaper than PgF 2α. Conclusion: Extra-amniotic saline infusion is as effective as PgF 2α, safe, but much cheaper than PgF 2α and should be seriously considered as a method of first choice in resource-poor settings.