Induction of Labour with Prostaglandin with or Without Vaginal Douching
Objective: To assess the induction of labour with prostaglandin with or without vaginal douching.
Methodology: This randomized controlled trial study was conducted in the department of Obstetrics & Gynecology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital / AK CMH Muzaffarabad Azad Kashmir from October 2019 to May 2020. Pregnant women of age 18-40 years, having single tone pregnancy, at term were included in the study. Vaginal douching was done with 0.9% NaCl serum (20cc) at the time of inserting dinoprostone. In the study group 10 mg PGE2 slow release system was used for vaginal insertion, right after washing the vagina and dinoprostone was inserted without any additional intervention among the women in control group. The standard protocol of the hospital was followed after the onset of active labour.
Results: There was no significant (p-value > 0.05) difference in basic demographic information between vaginal douching group and the control group. The mean duration of dinoprostone kept intravaginally (10.87 ± 6.92 vs. 7.69 ± 4.89 h), time to reach active phase of labour (11.26 ± 7.38h vs 15.32 ± 11.69h) and duration from dinoprostone insertion to total cervical dilatation (17.63 ± 12.24 vs 14.21 ± 7.87h) were noted significantly (p-value <0.05) less in vaginal douching group.
Conclusion: The bioavailability of prostaglandin E2 can be improved by vaginal douching before intravaginal administration of dinoprostone. Vaginal washing before insertion of dinoprostone may improve the entrance of PGE2 into circulation by increasing the vaginal pH.
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