Efficacy of outpatient induction with low-dose intravaginal prostaglandin E2: a randomized, double-blind, placebo-controlled trial

American Journal of Obstetrics and Gynecology
J M O'BrienB M Sibai

Abstract

Our purpose was to determine whether a protocol for outpatient induction is safe and effective for initiating labor. A randomized, double-blind, placebo-controlled trial was performed with 100 low-risk patients having well-dated pregnancies. Women with a Bishop score < or = 6 at 38 to 40 weeks' gestation were administered either 2 mg of intravaginal prostaglandin E2 gel or placebo for 5 consecutive days as outpatients while undergoing fetal monitoring. The median interval from randomization to delivery was 4 days in the prostaglandin E2 group (range 0 to 28 days) versus 10 days in the placebo group (range 0 to 26 days, p = 0.002). Twenty-seven of 50 patients (54%) in the prostaglandin E2 group were admitted for labor during the dosing interval compared with 10 placebo-treated patients (20%, p = 0.001). The mean gestational age at delivery was significantly reduced in the treatment group (39.9 +/- 1.0 weeks vs 40.5 +/- 0.99 weeks, p = 0.003) as was the incidence of postdates pregnancy (40% vs 66%, p = 0.016). Hyperstimulation was observed in one prostaglandin E2-treated patient, but no intervention was required. Outpatient low-dose prostaglandin E2 gel administration is effective for initiating labor in patients with an unfavora...Continue Reading

Associated Clinical Trials

Apr 29, 2016·Spencer G. KuperSpencer G. Kuper

References

Oct 11, 1991·American Journal of Obstetrics and Gynecology·J OwenM C Smith
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Citations

Apr 9, 2013·Women and Birth : Journal of the Australian College of Midwives·Deborah TurnbullChris Wilkinson
Apr 1, 1997·Obstetrics and Gynecology·L Sanchez-RamosF L Gaudier
Sep 22, 1998·Clinical Obstetrics and Gynecology·R A Chez
Jun 6, 2009·Journal of Perinatal Medicine·Werner H Rath
Apr 30, 2014·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Ekaterina MishaninaCatherine Meads
Sep 15, 2015·Seminars in Perinatology·Jennifer M H Amorosa, Joanne L Stone
Jul 31, 2014·BMC Health Services Research·Kirsten HowardDeborah Turnbull
Sep 14, 2017·The Cochrane Database of Systematic Reviews·Joshua P VogelZarko Alfirevic
Apr 20, 2007·The Cochrane Database of Systematic Reviews·L DuleyJ F King
Dec 3, 2009·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Isaac Blickstein
Jun 20, 2014·The Cochrane Database of Systematic Reviews·Jane ThomasAnthony J Kelly
Sep 11, 2013·Australian Health Review : a Publication of the Australian Hospital Association·Pamela L AdelsonDeborah A Turnbull
Mar 4, 2020·American Journal of Perinatology·Michelle J WangLorie M Harper

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