Document Detail

Pre-eclampsia and induction of labor: a randomized comparison of prostaglandin E2 as an intracervical gel, with oxytocin immediately, or as a sustained-release vaginal insert.
MedLine Citation:
PMID:  9822501     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Our purpose was to compare the efficacy of commercial prostaglandin E2 products, in combination with oxytocin, for the initiation of labor among pregnancies with pre-eclampsia. STUDY DESIGN: Patients with pregnancy-induced hypertension and with either proteinuria or other end-organ damage were enrolled if they had an unfavorable Bishop score (</=4) and were eligible to undergo labor. Each was randomly assigned to receive prostaglandin E2 either as a 0. 5-mg intracervical gel (Prepidil) or as a 10-mg controlled-release vaginal insert (Cervidil). Oxytocin was begun either immediately after instillation of the gel or was delayed until after removal of the insert. RESULTS: Of the 70 patients, there were no differences between the Prepidil (n = 34) and the Cervidil (n = 36) groups in maternal demographics, gestational age, parity, and predose Bishop score. There was a mean 14.3-hour difference in the duration from beginning therapy until vaginal delivery in the Prepidil group than in the Cervidil group (11.5 +/- 2.3 hours vs 25.8 +/- 6.9 hours, P <. 001). This time difference, which favored use of Prepidil-immediate oxytocin, remained significant after parity (nulliparous: 20 hours, P <.005; multiparous: 12 hours, P <.01) and gestational age were controlled (preterm: 15.5 hours, P <.01; term: 13.3 hours, P <.01). CONCLUSION: Use of combined intracervical prostaglandin E2 gel-immediate oxytocin therapy was more effective in shortening the induction-to-vaginal delivery time than use of a controlled-release prostaglandin E2 vaginal insert.
M H Hennessey; W F Rayburn; J D Stewart; E C Liles
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  179     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1998-12-23     Completed Date:  1998-12-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1204-9     Citation Subset:  AIM; IM    
Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, OK 73190, USA.
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MeSH Terms
Administration, Intravaginal
Cervix Uteri
Delayed-Action Preparations
Delivery, Obstetric
Dinoprostone / administration & dosage*,  therapeutic use
Drug Therapy, Combination
Labor, Induced / methods*
Oxytocin / therapeutic use*
Pre-Eclampsia / physiopathology*
Time Factors
Reg. No./Substance:
0/Delayed-Action Preparations; 0/Gels; 363-24-6/Dinoprostone; 50-56-6/Oxytocin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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