A Clinical Study on the Elective Induction of Labor

Kim, D Y; Chung, S M; Song, C H; Chung, H B; Shin, J H; Hong, S Y; Son, D W

Abstract

Prostaglandin E2 is capable of ripening the unfavourable cervix and thus improving the outcome of induced labor by altering the state of the cervix and myometrial fibers of the lower uterine segment. This study was performed to compare the clinical efficiency of PGE and oxytocin for the elective induction in term pregancies. A retrospective randomized study was undertaken comparing the efficacy of a 3mg prostaglandin E2 vaginal suppository (group 1, n 80), intravenous oxytocin (group 2, n=72), and prostaglandin E plus intravenous oxytocin (group 3, n 74) for the elective induction of labor. The results of above three groups were also compared with normal spontaneous labor group (control group, n 75) as a control. Gestational age of every subject was between 38 and 42 weeks with Bishops score from 1 to 6. The duration of 1st stage, cesarean section rate, Apgar score, incidence of neonatal complication, and side effect of every group were evaluated. The results were as follows; 1. In nulliparous women with Bishops score of 4 or less, the duration of the first stage of labor was significantly shortened in the group 1, 2, and 3 compared with that of control group. (P<0.0001, respectively) The duration was significantly shortened in the group 3 compared with group 1 or 2 (P<0.0001, respectively) while the difference was not found between group 1 and 2. (P>0.05) 2. In parous women with Bishops score of 4 or less, the duration of the first stage of labor was significantly shortened in the group 1, 2, and 3 compared with that of control group. (P<0.0001, respectively) No difference was found among group 1, 2, and 3. (P>0.05, respectively) 3. In nulliparous women with Bishops score of 5 or more, the duration of the first stage of labor was significantly shortened in the group I, 2, and 3 compared with that of control group. (P<0.0001, respectively) The duration was significantly shortened in the group 3 compared with group 1 or 2 (P<0.0001, respectively) while the difference was not found between group 1 and 2. (P>0.05).4. In parous women with Bishops score of 5 or more, the duration of the first stage of labor was significantly shortened in the group 2 and 3 compared with that of control. (P<0.0001, respectively) No difference was found between group 1 and control group (P>0.05) and no difference were found among group 1, 2 and 3 (P>0.05, respectively). 5. The Cesarean section rate were 16%, 8.7%, 12.5%, and 6.8% for control, group 1, group 2, and group 3, respectively. 6. There were no significant differences in 1, 5-min Apgar score, and the incidence of neonatal complication in each group. 7. The side effects (nausea, vomiting, headache, hypertonus, and fever) developed in 9 case (3.0%) of group 1, 2, and 3. There were no significant differences in side effect in each group.