Oral oxytocics for induction of labor. A randomized study of prostaglandin E2 tablets and demoxytocin resoriblets.

Abstract

A randomized comparative study of 387 consecutive patients admitted for induction of labor was carried out using two orally administered oxytocics (prostaglandin E2 tablets (Prostin) or Demoxytocin resoriblets for buccal administration (Sandopart)), the results of which are reported here. One-hundred and twenty-three cases were suitable for primary amniotomy; of these 48 were given PGE2 tablets and 75 received demoxytocin resoriblets. In a further 264 cases, primary amniotomy was inadvisable and of these, 133 patients were allotted to the PGE2 treatment group and 131 to treatment with demoxytocin. A significantly higher success rate was observed (p less than 0.05) in the PGE2 group in cases where primary amniotomy had been carried out, as compared with the demoxytocin group. Parturition was successfully induced in 82.0% of the patients given PGE2 tablets, as against only 63.4% of those receiving demoxytocin following 2 days of stimulation without primary amniotomy. This difference is statistically significant at the 0.001 level, and presumably due to the highly significant difference (p less than 0.0001) between patients with a Bishop score of 5 or less, where induction was successful in 75.4% given PGE2 tablets, in contrast to a success rate of only 36.7% in patients receiving demoxytocin resoriblets. No difference was observed in the success rate between the two treatment groups when the Bishop score was 6 or more. No difference was recorded in the incidence of fetal distress, instrumental delivery or low Apgar score between the two treatment groups. However, a higher incidence of vomiting and diarrhea were observed in patients treated with PGE2 tablets (11%) as compared with those receiving demoxytocin (1.5%). There was no difference with regard to the induction-delivery time, nor to the different stages of labor between otherwise comparable treatment groups when the induction was successful. It is concluded in respect of induction of labor using orally administered oxytocics that PGE2 (tablets) are preferable to demoxytocin (resoriblets) as it is the more effective of the two.