Preinduction cervical ripening with sequential use of prostaglandin E2 gel.

Two hundred patients received a prostaglandin E2-containing gel for preinduction cervical ripening. The gel was administered every 6 hours until a Bishop score greater than or equal to 7 was obtained or the attending physician deemed induction necessary. Forty-eight percent of the patients labored "spontaneously" after one or more gel applications. The average cumulative change in Bishop score with sequential application of the gel was 2.7. Sequential application of the prostaglandin gel proved no more effective in the process of preinduction cervical ripening than single application of the gel with a similar period of observation.