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COMPARISON OF PROSTAGLANDIN E2 GEL AND PROSTAGLANDIN VAGINAL TABLETS FOR INDUCTION OF LABOR

*Dr Sumaira Zareen

Objectives. Our current study was intended to explore the more effective form between vaginal gel and vaginal tablet for induction of labor. This study will help clinician to choose the better drug administering forms. Material and Methods: This was a randomized control trial from January 2013 to June 2013, in Department of Gynecology and Obstetrics, Abbassi Shaheed Hospital, Karachi, through non-probability purposive technique on 218 pregnant females after taking ethical approval. The ethical approval for this study was taken from ethics review committee. Women between 20-45 years of age, bearing single pregnancy with cephalic presentation of the viable fetus, presenting in the labor room after gestational age of 37 weeks (as confirmed by early scan), for labor induction were included in the study. The two groups were Group A, in which women were administered with dinoprostone (PGE 2 analog) gel [1mg/2mg] intravaginally. While Group B participants were administered with dinoprostone tablet [3 mg] intravaginally. Fetal outcomes and the association of labor induction with age was noted. Version 16 of SPSS was used for the data analysis. Descriptive analysis was performed. Chis-square test was used to assess the different with p value of <0.05. Results: In a total of 218 patients, the mean age of females was 32.12±7.69 years in group A and 33.17±7.16 years in group B. Also, the average time from induction to delivery in group A was recorded as 11.88±2.68 hours and in group B as 11.95±2.83 hours. Bishop score of more than 6 was observed in 83(76.1%) from group A and 67(61.5%) females from group B (p =0.019). Correspondingly,88(80.7%) females of group A and 71(65.1%) in group B had 3 uterine contractions of 40 seconds in 10 minutes. 83(76.1%) of females in group A and 67(61.5%)in group B had effective induction (p value =0.019). Age group for women from 41 to 45 years had a significant association (p=0.009) Moreover, this effectiveness when compared among primigravida of both groups, a statistical significance (p value =0.012) was observed. Conclusion: Our study predicted the preeminence role of PGE 2 vaginal gel over PGE 2 vaginal tablets. Vaginal gel was more effective as compared to the oral form for the induction of labor. However, PGE 2 vaginal gel was observed to decline maternal morbidity and mortality significantly, at the same time improving fetal outcome. Key Word: Labor induction, Prostaglandins, dinoprostone, maternal morbidity.

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