Comparative trial of extra-amniotic and vaginal prostaglandin E₂in tylose gel for induction of labor

Abstract

Two hundred and sixty-one patients of varying parity and cervical "ripeness" were given Prostaglandin E2 (PCE2) in tylose gel either vaginally (2.0 mgm) or extraamniotically (0.3 mgm) prior to planned surgical induction. Surgical inductions was avoided in 52 per cent of the vaginal group and 40 per cent of the extra-amniotic group. When subdivided according to parity and cervical ripeness, both groups were comparable except in the multigravid patients with high cervical 'scores', when the vaginal route was significantly more likely to establish labor. Both groups were without significant ill-effects to the mother or fetus.

Prostaglandins and Parturition

“…A clinical trial of the comparative efficacy of the intravaginal method with the extra-amniotic instillation was conducted. 72 Patients were randomly assigned to either receive PGE 2 gel 2 mg instilled in the posterior vaginal fornix, or 0.3 mg instilled into the extra-amniotic space just inside the internal os. AROM was performed when the cervix was dilated 5 cm, or if labor had not been established within 20 hours.…”

Review article

“…Another simplified technique was devised by MCKENZIE [24] and THIERY [37] by which a celulose viscous gel is administered in large doses (2-4 mg) in the posterior vaginal fornix [26,37]. Comparative studies of both methods [11] have not found any significant differences in the improvement of cervical score using PGE extraamniotically or intra-vaginally. Recently estradiol valerate at a dose of 150mg in a gel form introduced transcervically [19, 34,38] or intravaginaUy [4] has been employed, PINTO [31] has also used doses of estrogen intravenously.…”