Abstract
OBJECTIVE: Our purpose was to compare the safety and efficacy of intravaginal prostaglandin E 1, misoprostol, with that of intracervical prostaglandin E 2 (Prepidil gel) for labor induction. STUDY DESIGN: One hundred three patients with an indication for induction of labor were randomly assigned to induction with prostaglandin E 1, 50 μg intravaginally, or with Prepidil gel, 0.5 mg intracervically, every 4 hours until active labor. RESULTS: Four patients were excluded, leaving 49 patients who received prostaglandin E 1 and 50 who received prostaglandin E 2. The time from start of induction to vaginal delivery was significantly shorter in the prostaglandin E 1 group (11.4 vs 18.9 hours, p < 0.001), and fewer patients in the prostaglandin E 1 group required oxytocin augmentation (23% vs 55%, p < 0.005). No significant differences were noted in mode of delivery or in adverse maternal, fetal, or neonatal effects. CONCLUSION: Intravaginal prostaglandin E 1 is a more effective, lower-cost agent for induction of labor than is intracervical prostaglandin E 2 gel and is comparable in safety.
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