Rachel Alexander, Thanku Thomas Koshy
BACKGROUND Induction of labour is the process of initiation of uterine contractions for the purpose of vaginal delivery. Use of prostaglandins in induction of labour improves the obstetric outcomes in complicated cases such as prolonged deliveries. The aims and objectives of the study were to compare the effects of- 1. Prostaglandin E1 (PGE1) and prostaglandin E2 (PGE2) for prelabour ripening of unfavourable uterine cervix. 2. PGE1 and PGE2 on maternal complexities and neonatal outcomes. MATERIALS AND METHODS This was a prospective study conducted on 226 pregnant women with gestational age ≥37 weeks during one-year period in the Department of Obstetrics and Gynaecology of Government TD Medical College, Alappuzha, Kerala. All the 226 patients were divided into two groups. Group 1 contains 179 patients who received intravaginal PGE1, (Tablet Misoprostol 25 μg or 50 μg) inserted in the posterior vaginal fornix under all aseptic precautions. Group 2 contains 47 patients who received intracervical PGE2, (dinoprostone gel, 0.5 mg). Analysis and comparison of various parameters between the two groups such as Bishop score before and after administration of drug, mode of delivery, neonatal outcome and maternal complications were noted and analysed using Chi-square. RESULTS Majority of the patients in both the groups were in the age of 21-30 years. Maximum patients had a Bishop’s score of 4 in both PGE1 and PGE2 groups. There was significant difference in age and parity of both groups. In our study, we found only 2 cases of postpartum haemorrhage among the entire sample (group I and group II). We found significant difference in the occurrence of hyperstimulation among PGE1 and PGE2; whereas, there was no significant difference in the occurrence of maternal pyrexia among two groups. CONCLUSION PGE1 and PGE2 drugs have similar efficacy in induction of labour, but PGE1 is associated with more side effects. Cost wise PGE1 is more cost effective than PGE2.
