Influence of preinduction prostaglandin E2 vaginal gel on cervical ripening and labor.

A sterile gel containing prostaglandin (PG) E2 (2 mg PGE2 10 ml gel) was instilled vaginally in 65 primigravidas with unripe cervixes to accelerate ripening before planned surgical induction of labor. The patients treated with the gel were compared with 30 similar untreated controls. In the PGE2-treated group a significant improvement on cervical score was achieved before labor began, and 47% began to labor "spontaneously" without further treatment. Both the duration of subsequent labor and the incidence of cesarean section were significantly lower in the PGE2-treated group. There were no unwanted fetal or maternal effects. Pretreatment with intravaginal PGE2 gel reduces the risk of failed induction and provides the mother with an experience similar to spontaneous labor without harming the fetus.