Experience with an industrially manufactured gel PGE₂ for cervical priming

Summary

An industrially manufactured ready-to-use PGE₂ gel for cervical ripening was clinically evaluated. The study included 42 primiparous and eight multiparous women with an unfavourable cervix (Bishop score ⩽ 5) admitted to hospital for induction of labour on medical grounds. PGE₂, 0.5 mg, in 2 ml triacetin gel was instilled into the cervical canal. In nine patients (18%) the gel induced labour and subsequent delivery. In the remaining women the mean Bishop score increased from 3.0 to 7.7 during a 24-h period and labour was induced by either i.v. oxytocin or PGF_2α. None of the 50 patients experienced gastrointestinal side effects during pretreatment with PGE₂. In 50% of the patients slight uterine contractility was noticed. All patients went into labour. The incidence of Cesarean section was 10%. Except for two patients treated because of intrauterine fetal death there was no perinatal mortality. The 5-min Apgar score was 8 or more in all newborn but 1. The main advantage of the new gel is that it is ready to use without any mixing procedure. Moreover, the stability of PGE₂ is sufficient to allow routine clinical use.