Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term

Vaginal PGE2 may be more effective than placebo for induction of labour at term. They are effective for reducing risk of the cervix remaining unfavourable. They increase uterine hyperstimulation with fetal heart changes but do not effect or may reduce caesarean section rates.

A Cochrane review included 70 studies with a total of 11 487 women. Vaginal PGE2 compared with placebo or no treatment non-significantly reduced the rate of unsuccessful vaginal delivery within 24 hours (RR 0.32, 95% CI 0.02 to 4.83; 2 trials, n=384). The risk of the cervix remaining unfavourable or unchanged was reduced (RR 0.41, 95% CI 0.27 to 0.65; 6 trials, n=567).There was a trend for lower caesarean section rates (RR 0.91, 95% CI 0.81 to 1.02; 36 trials, n=6599) although the risk of uterine hyperstimulation with fetal heart rate changes was increased (RR 3.16, 95% CI 1.67 to 5.98; 15 trials, n=1359).

PGE2 tablet, gel and pessary appear to be equally effective.

Ədəbiyyat

1. Kelly AJ, Malik S, Smith L, Kavanagh J, Thomas J. Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term. Cochrane Database Syst Rev 2009;(4):CD003101 [Assessed as up-to-date: 1 March 2014].