Labor Induction in Primiparous Women and Women with an Unripe Cervix

Anna Thorbiörnson, Tomisl

Abstract

Objective: To compare the efficacy and safety with oral prostaglandin in solution versus vaginal prostaglandin gel for labour induction. Design: A retrospective observational study. Methods: Data from obstetric records in a university hospital in Sweden 2012-2013. Results: In all women, oral prostaglandin resulted in vaginal birth <24 in 66% compared to 80% with vaginal treatment (p < 0.001), and caesarean section in 19% versus 32% (p = 0.02). In primiparous women, oral prostaglandin lead to vaginal birth <24 hours in 54% compared to 71% (p = 0.01), and caesarean section in 25% versus 41% (p = 0.03). In women with an unripe cervix, oral prostaglandin lead to vaginal birth < 24 hours in 66% compared to 79% (p = 0.01), and caesarean section in 21% versus 33% (p = 0.04). Despite a longer induction to vaginal delivery interval with oral prostaglandin, the rates of obstetric bleeding, chorioamnionitis, uterine hyperstimulation and neonatal asphyxia were not increased. Conclusions: Oral prostaglandin was less effective than vaginal prostaglandin in achieving vaginal birth < 24 hours. However, oral prostaglandin was safer, since it resulted in fewer caesarean sections in all women, primiparous women and women with an unripe cervix.