Comparative study of induction of labour with dinoprostone gel versus mechanical dilatation in unfavorable cervix (low Bishops Score)

Abstract

Background: Induction of labour is defined as initiation of uterine contractions before spontaneous onset of labour. This observational study compares the effect of prostaglandin E2 (PGE2) and extra amniotic saline infusion (EASI) for pre-labour ripening of unfavourable uterine cervix. Methods: This is a prospective and randomised study was conducted in the Department of Obstetrics and Gynaecology, in a tertiary care teaching hospital over a period of six months. Patient admitted for induction of labour were randomized to receive intravaginal dinoprostone or intracervical Foley’s catheter. Patient not entering active labour and having rupture membranes or arrest of dilatation received IV oxytocin. Results: A total of 140 women with gestational ages of 37-42 wks were enrolled in this study. Of the 140 pregnant women, 70 were assigned to the PGE 2 group and 70 to the foley’s group. Baseline characteristics of both groups were similar including age, gravidity, parity. The mean gestational age was statistically higher in the PGE2 group; however, this was clinically not significant. Overall indication for induction were also similar across intervention apart from more small for gestational age (SGA) or IUGR induction being performed with Foleys catheter. Additionally, cervical station at the time of induction did not differ across intervention group. Conclusions: Group A was associated with more rapid cervical ripening, shorten induction to vaginal delivery interval and greater no. of vaginal deliveries within 24 hours.