Prostaglandin E2 Tablets Research Articles

Pre-labour rupture of membranes with an unripe cervix: A random trial of management

SummaryFifty primigravid patients at term with ruptured membranes before labour and an unripe cervix were allocated at random to be managed by vaginal prostaglandin E2 tablets or by intravenous oxytocin infusion. With prostaglandin there were longer intervals from treatment to the onset of contractions, to the second stage of labour and to delivery. The incidences of assisted delivery in general and caesarean section in particular were not increased. Two neonates, both from the prostaglandin patients, became pyrexial and were treated with antibiotics, but there were no serious infections in either group. We conclude that there are no advantages to initial treatment with prostaglandin E2 vaginal tablets over the use of an oxytocin infusion.

Outcome of labour in patients with a lower segment caesarean scar

SummarySummaryOf 450 patients with previous caesarean sections, 280 (62 per cent) were given a trial for vaginal delivery, with a success rate of 58 per cent. Vaginal delivery was achieved by 56 per cent of patients who underwent the previous caesarean section for obstructed labour or failure to progress. Previous vaginal delivery favours a successful outcome of labour. Twenty-three per cent of the patients received either intravaginal prostaglandin E2 tablets or oxytocin for induction or augmentation of labour. The drugs were found to be safe and effective in increasing the vaginal delivery rate. There were four cases of scar disruption (1.4 per cent); one was related to oxytocin infusion. Vaginal breech delivery was successful in six patients without maternal and fetal morbidity or mortality. Trial for vaginal delivery may be allowed in selected patients with a previous lower segment caesarean section in a well equipped hospital department.

Labor induction by intravaginal administration of prostaglandin E2 tablets

Between 1982 and 1984, at Graz University Obstetric and Gynaecological Clinic, labour was induced in 307 women (146 primiparae and 161 multiparae) by intravaginal administration of 3 mg prostaglandin (PG) E2 tablets, because birth was overdue or because labour was irregular. No risk factors were present when PG was administered: signs of deficiency or postmaturity, or twisted cord, were ruled out. The following complications were evaluated: birth rate and induction-birth interval in relation to cervical maturity and parity. The number of complications was low. It was unrelated to cervical maturity and only partially to parity. Birth was induced successfully with a single dose of 3 mg PG E2 in over 80% of the primiparae and over 90% of the multiparae. The majority of the primiparae and all the remaining multiparae were successfully delivered with a second dose; no relationship between birth rate and cervical maturity was established. Among the primiparae with a low degree of cervical maturity the child was born within 12 hours in over 50% of the cases, among primiparae with more mature cervices in almost 90%. Among the multiparae, the child was born within 12 hours in 90% of the cases regardless of the state of cervical maturity. It is concluded from these results that with appropriate monitoring of birth, intravaginal administration of PG E2 tablets is an efficient and easily managed method of inducing birth at term, involving little risk.

Induction of Labor with and without Primary Amniotomy

Comparative studies suggest that prostaglandin E2 (PGE2), given orally, is at least as effective as intravenous oxytocin for the induction of labor. The authors here report a large consecutive, randomized study designed to evaluate the effectiveness and safety of each treatment, with and without amniotomy. Four hundred and seventy-one consecutive patients admitted for induction were studied. The condition of the uterine cervix was evaluated by the Bishop scoring method. The material was divided into five groups, as shown in Table 1. Primary amniotomy was performed in 227 cases with the head engaged, or nearly engaged, and a ripe cervix. If no contractions were achieved after 4 hours, the patients were randomized; 57 had PGE2 tablets, and 46 had oxytocin intravenously.

Induction of labour with oral prostaglandin E2: a Canadian multicentre study.

Prostaglandin E2 (PgE2) tablets were administered orally for the induction of labour at or near term to 680 patients. Successful vaginal delivery occurred in 81.8% of patients with a mean total dose of 3.7 mg and a mean induction-delivery interval of 7.1 hours. PgE2 was most efficacious in parous patients and in those with high Bishop scores. The most common maternal side-effects were gastro-intestinal in nature and uterine hypertonus was observed in six patients. Foetal heart rate changes occurred in fifty patients.

Prostaglandin E2 tablets used intravaginally for the induction of labour.

Prostaglandin E2 tablets were administered intravaginally 505 patients for the induction of labour, without amniotomy, using doses ranging from 1 to 5 mg as a single insertion. The advantages and limitations of this method of induction of labour are discussed.

The routine use of oral prostaglandin e2 tablets for induction or augmentation of labour

The use of oral prostaglandin E2 (PGE2) tablets is an effective and safe adjunct to low amniotomy for the induction of labour at term. Routine use of this regimen and the use of oral PGE2 tablets for augmentation of spontaneous labour has shown that the method is very effective in multiparous patients, but much less so in primiparous patients. Success or failure could not be predicted by the pre-induction Bishop score. The incidence of gastro-intestinal side effect is dose dependent, but is low in multiparous patients.

Inducing labor with oral prostaglandin E2 tablets.

Labor was successfully induced by forewater amniotomy and oral administration of prostaglandin E2 tablets in 91.3% of 153 women with singleton pregnancies. Deliveries occurred within 12 hours for more than 90% of the successfully induced patients. Although not statistically significant, a higher pelvic score appeared to be associated with shorter induction-to-delivery intervals. There were no harmful side effects for either mother or baby; only 14.5% experienced minor side effects, primarily gastrointestinal upsets.

Letter: Uterine hypertonus after induction of labour with prostaglandin E2 tablets.

Letter: Uterine hypertonus after induction of labour with prostaglandin E2 tablets.

PROSTAGLANDIN E2 TABLETS COMPARED WITH INTRAVENOUS OXYTOCIN IN INDUCTION OF LABOUR

Stimulation of uterine activity after amniotomy has been carried out with prostaglandin E2 (PGE2) tablets in two dosage regimens and with intravenous oxytocin. Oxytocin stimulation was the most successful. The difference in success rate was most marked in nulliparous patients and those with low Bishop score.

Induction of Labour Using Oral Prostaglandin E2 Tablets

Labour was induced in 91 patients by means of low amniotomy and an escalating dose of oral prostaglandin E2 tablets* up to a maximum dose of 1.5 mg hourly. This regime led to vaginal delivery in 91.2% of patients. The induction delivery interval was 11.2 ± 4.9 and 7.5 ± 4.5 hours for primiparous and multiparous patients respectively. The incidence of gastrointestinal side-effects was 15.4%, with 6 patients being unable to tolerate the regime. It is suggested that a higher hourly dose is necessary for primiparous patients with a low Bishop score.

The effects on platelet aggregation of oral prostaglandin E2 used for the induction of labour.

Secondary ADP induced platelet aggregation was inhibited in 17 patients after the administration of oral prostaglandin E2 tablets for the induction of labour. Primary ADP induced aggregation was shown to be inhibited by oral prostglandin E2 when the platelets responded to the lower concentration of 0-5 mug/ml of ADP. This inhibition was not detectable when the higher concentration of 1-0 mug/ml ADP was necessary. There would appear to be a decreased risk of thrombosis initiated by platelet aggregation as a result of using oral PGE2 tablets for inducing labour.

Induction of Labour with Prostaglandin E2 Tablets

Prostaglandin E2 tablets were administered orally following amniotomy to 46 primagravid and 54 multiparous women at or near term. Of these, 96 women had vaginal delivery with an average induction-delivery interval of 8 1/2 hours. Vomiting and or diarrhoea occurred in 9 women. No adverse effects on the foetus were apparent. The safety, ease and convenience of administration were obvious to the patients and staff.

Induction of labour with prostaglandin E2 tablets.

SummaryPGE2 tablets were administered for induction of labour to 47 clinically normal patients at term who, one hour after amniotomy, had less than 100 Montevideo Units of uterine activity. The dosage of PGE2 was individually adjusted and never exceeded 2.0 mg. two‐hourly. One multiparous patient was given oxytocin for acceleration of labour. The other 46 patients required no other oxytocic drugs.