Vaginal prostaglandin E2 versus oxytocin for induction of labor in women with prelabor rupture of membranes at term

Abstract

Aims: Majority of women with prelabor rupture of membranes (PROM) at term will go in to labor within 24 hours. However early delivery will reduce the maternal and fetal infection and reduce the need for antibiotics for newborn. It will also increase maternal satisfaction. Oxytocin is being used for several decades for induction of labor in PROM. Prostaglandin E2 (PGE2) has shown promising results for the same purpose. A randomized controlled trial carried out to determine the effectiveness and acceptability of vaginal prostaglandin E2 for induction of labor in women with PROM at term. Methods: A total of 162 women with singleton pregnancies at >37 weeks, cephalic presentations, Bishop scores of and#60;6 were randomly allocated to receive either oxytocin or vaginal PGE2. The primary outcome measure was induction to delivery interval. Secondary outcomes were caesarean section rate, postpartum maternal fever, neonatal fever, and special care baby unit (SCBU) admissions. Results: The induction to delivery interval was not significantly different (p -0.558) in oxytocin group (630.9 + 31.1 min) as compared to PGE2 group (635.2 + 27.1 min). Incidence of postpartum maternal fever, neonatal fever, and SCBU admission were almost similar in both groups. Uncomplicated vaginal delivery rates 2022were almost same in both groups (65.3% in PG group and 62.5% in oxytocin group). Conclusion: Vaginal PGE2 appears to be as efficient as oxytocin for labor induction in term pregnancies with PROM and unfavorable cervices. However PGE2 doesn’t have additional advantages over oxytocin. As vaginal PGE2 is more expensive, it is rational to opt for oxytocin infusion to induce labor in term prelabor rupture of membranes accompanied with low Bishop’s scores.