Induction of Labor with Oral Prostaglandin E2 or E1 Plus Oxytocin

Choi, Jin Ho; Koo, Tae Bon; Park, Il Soo

Abstract

OBJECTIVE
Our purpose was to complete delivery during daytime through rapid and safe management with oral prostaglandin plus oxytocin, and to reduce the duration of induced labor, hospital stay and dispersion of human power.
METHODS
Ninety pregnancies requiring induction of labor between December 1998 and July 1999 were analyzed prospectively. Patients were assigned to receive either oral PGE2 or oral PGE1. In one group, labor induction was performed with 0.5 mg of oral PGE2 (group 1, n=46), was orally taken every one hour since 06:00 AM to 09:00 AM and intravenous oxytocin infusion (The beginning dose was 2 mU/min, the dose increased by 2 mU/30 min) beginning at 09:00 AM, and in the other group (group 2, n=44), 100 microgram of PGE1 was orally taken at 11:00 PM the day before oxytocin infusion was commenced at 07:00 AM. If there was uterine contraction of more than 200 Montevideo units, intravenous oxytocin would not be given.
RESULTS
The mean time (+/-standard deviation) to active phase labor (cervical dilatation more than 3 cm and uterine contraction more than 200 Montevideo units) with PGE2 group was 335.16+/-157.89 minutes versus 534.16+/-211.79 minutes with PGE1 group (P<0.001). The mean time from active phase to birth was 182.8+/-93 minutes in group 1 versus 236.4+/-88.8 minutes (P<0.001). These significances were due to the difference of time interval from taking prostaglandins to infusion of oxytocin between the two groups. The time zone of expected delivery was 13:28 PM to 15:48 PM and 10:22 AM to 13:18 PM (Confidence Interval 95%). The induction failure rates were 10.87% versus 9.09%. The induction failure rate was significantly different according to Bishop score (if <4, 15.3% versus if >or= 4, 0%) and the cesarean section rate was also (if < 4, 40.7% versus if >or= 4, 19.4%) in the two groups (P<0.05). There were no clinical or statistical differences in demographic data, clinical characteristics, maternal outcomes and complications, and neonatal outcomes.
CONCLUSION
Both may be proper methods of inducing delivery during daytime and begun at outpatient office base.