Induction of labor single vaginal PGE 2 vs early Amniotomy and I/V oxytocin

Abstract

Objective: To compare two methods of induction of labour. Amniotomy with intravenous oxytocin infusion versus single use of prostaglandin E2 vaginal tablet. Design Perspective randomized clinical trial . Setting: The department of Gynae & Obs Nishtar Hospital Multan & Ganga Ram hospital lahore 100 patients were recruited .50 were randomized for amniotomy followed by oxytocin infusion. Second group underwent labour induction with PGE2 which was repeated after 6 hours, if n o change in bishop score is observed. Period: 17 .2 .2004 to 17 .2.2005 Results: In the study the results regarding mean Bishop score change, duration of labour and apgar score at 5 minutes were comparable in both groups. In the group 2 mean induction to delivery time was 9 hours.(6-12 hrs).The mean cervical change score was 8.5 Duration of labour in group 2 was in the mean of 7hrs. In group 1 mean cervical change was 7.5 (range5-7), induction to delivery time was 10.5 hrs. The duration of labour was 7.5 hrs. Analgesic requirements varied in both groups. No patient with PGE2 required pain relief before membrane rupture. In the oxytocin group narcotic analgesia was given from the start of uterine contractions. Conclusion: PGE2 vaginal tablet for induction of labour in case of unfavourable cervix is superior to use of amniotomy and oxytocin. It was found to be safe and effective with minimum of patient interference.