Effectiveness of Oral PGE1 versus Intracervical PGE2 in Induction of Labor

Abstract

Objective: To determine the effectiveness of oral PGE1 versus intracervical PGE2 in terms of induction of labor, mode of delivery and feto-maternal outcomes.

Methodology: A comparative study was carried out at department of gynecology and obstetrics of THQ Hospital Liaquatpur from April 2022 to September 2022. Pregnant women at term, with a singleton alive pregnancy, clinically favorable cervix, determined by Bishop score of 6 or less, who are not currently in active labor, and have not received any other cervical ripening or induction agents in the 24 hours prior to study enrollment were included. Cases were divided into two groups: one group receiving oral PGE1 and the other group receiving intracervical PGE2. Outcomes was evaluated in terms of time to onset of active labor, duration of labor, mode of delivery and feto-maternal complications. All the information was collected via study proforma and SPSS version 26 was used for the data analysis.

Results: A total of 80 women were comparatively studied; their overall mean age was 27.37+3.02 years and overall mean gestational age was 38.0+1.10 weeks. Time of onset of active labor and duration of labor showed slightly decreased in Oral PGE1 group, while difference was statistically insignificant. C-section rates was12.8% in Oral PGE1 and 9.1% in Intracervical PGE2, with insignificant difference (p=0.609). Maternal complications including hyperstimulation of the uterus, fever, bleeding, and nausea/vomiting were statistically insignificant across the groups, though only bleeding showed a significant difference (p=0.012). Fetal outcomes, such as Apgar scores at 1 and 5 minutes, showed a significant difference at 1 minute (p=0.036) but not at 5 minutes. NICU admissions and mortality rates were also statistically insignificant between the groups (p->0.05).

Conclusion: Both oral PGE1 and intracervical PGE2 observed to be effective in inducing labor, with almost similar success rates and similar maternal and fetal outcomes. However, oral PGE1 appears to have a higher rate of bleeding compared to intracervical PGE2.